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Thread: Ob question

  1. #1
    Join Date
    Apr 2007

    Default Ob question

    AAPC: Back to School
    Does anyone know what procedure to use for Laparoscopy coverted into many laparotomy. DX is pelvic adhesions

  2. #2
    Join Date
    Apr 2007
    Idaho Falls, Idaho


    You would only code the laparotomy. Now depending on the amount of time spent on the laparoscopy, and how much of the procedure was done laparoscopically, you could code it with the 53 modifer and lower the amount billed, and code the laparotomy. The documentation MUST support that a significant portion was done laparoscopically. If they go in their with the laparoscope, can't do anything and open her up, just do the laparotomy.
    Tesja Erickson, CPC, CPMA COBGC, CEMC
    The Coding Surgeon
    Medical Documentation & Coding Consultant
    2012 AAPC Idaho Falls Chapter President
    2011 AAPC Idaho Falls Chapter President-Elect

  3. #3
    Join Date
    Apr 2007
    Portland Rose City Oregon Chapter


    You would just bill out the laparotomy with the dx V64.41 showing that it was a laparoscopic procedure converted to open along with the adhesion dx. Of course the V code would be after the adhesion dx code. If the provider spent an extensive amount of time on the laparoscopic portion, you could attach modifier 22 to the laparotomy code and increase your fee for the procedure and send the operative report along with the claim. Hope this helps!
    Amber Ruiz, CPC
    Women's Health Today

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