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Could use some help on general Surgery note 3

  1. #1
    Default Could use some help on general Surgery note 3
    Medical Coding Books
    POSTOPERATIVE DIAGNOSIS: DCIS of the left breast
    PROCEDURES PERFORMED: Isotope injection, this was all in the left breast, stereotactic wire localization, sentinel node biopsy, left lumpectomy, and insertion of Foley catheter.

    I'm missing something. I coded the DX and stereotactic wire localization, sentinel node biopsy, left lumpectomy, but will not except Foley catheter code for the breast. Has anyone done this? Just please throw me a bone.
    Last edited by Sage123; 01-27-2015 at 05:03 PM.

  2. #2
    Smile Re; breast
    Did your doctor implant the wire and do the injection?

  3. #3
    Location
    Albany, Oregon
    Posts
    53
    Red face Breast surgery
    Hello,

    Agree with Courtney - you can only charge (code) the stereotactic wire implant & injection of the "blue dye" if your surgeon performed this part of the procedure. In our practice, the mammographic radiologist inserts the catheter and injects the dye. During the course of the procedure while searching for the lymph node/s, my surgeon may inject a bit more dye. When this occurs, I charge (code) the injection only.

    Foleys: Most often insertion of foleys or drainage tubes is considered part of the procedure and therefore, not billable.

    Hope this is helpful,
    Pat Kidd
    pkidd@samhealth.org

  4. #4
    Default
    Thank you ladies. I'm still missing something but unsure what now. With your help I found 2 more CPT codes thank.

  5. Default
    Hi,
    Did you ever get the answer? I need one or two codes too. I've already codes the following:
    233.0
    38525
    38792
    19290
    I can't figure out what I'm missing... Please help

  6. Default
    To add to my previous post, I also added 19125. I'm just missing one code

    Please help

  7. Default
    19291 you are still missing adding the extra wires but i am afraid i am still missing a code on top of all the ones you have and this one

  8. Default
    Quote Originally Posted by jennileep View Post
    To add to my previous post, I also added 19125. I'm just missing one code

    Please help
    DID YOU EVER GET THE Last code? I've been racking my brain
    got all other notes ok but this one is a killer.
    thanks darlene

  9. Default op note #3
    I'm stuck on same case #3: So far, I have these codes...

    233.0
    19290 51 lt
    19291 lt
    19125 lt
    38792 lt
    38525 lt

    I'm thinking there is only one more code to this case. Help!! Thx.....

  10. Default
    Without the full op note it is hard to determine what was done, however, all of my surgeons when doing a sentinel node biopsy use two methods of mapping. If this is the case with your procedure you may want to consider 38900 which is intraoperative lymphatic mapping with dye if this procedure was done. Read your op note and if they say they injected the dye and found the blue nodes this is a billable code. Usually the nuclear med doc's will do the lymphoscintigraphy and the surgeons do the blue dye injection and intraoperative mapping.

    Hope this is helpful...

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