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What are the rules for lap?

  1. Question What are the rules for lap?
    Medical Coding Books
    I have a physician who will do an entire lap LAR, 44207 with mob splenic flexure, 44213 laparoscopically. After confirming anastomosis intact, he will remove the ports and enlarge the midline incision. He will then perform an open 44700. Most ins will not accept a claim with lap codes and open codes billed together. Are there rules for cases like this?

    I know if a lap is converted to an open, an open code is billed.

  2. Default
    As long as the Dr. is enlarging the incision and then performing that procedure totally separate, you should be able to send ins the documentation and fight it, or put a 59 mod on the 44700 to show that this is indeed a separate procedure.

  3. Default
    That's what I thought, just need confirmation. Thank you for taking the time to answer.

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