There are 3 options:
1) Report the lap splenic mobilization with the open colectomy code - 44140 + 44213
-This will certainly get 44213 denied since the open colectomy 44140 is not one of the listed primary codes for 44123
2) Switch the lap splenic mobilzation code to an open mobilization code - 44740 + 44139
-This presents an obvious audit issue, since on review the documentation would not support the open mobilization code 44139
3) Use an unlisted code for the lap splenic mobilization - 44140 + 44238 and specify the "Laparoscopic mobilization of the splenic flexure at the time of open colectomy is unlisted procedure. (And then price base on 44213)
My opinion is that option 3 is the only viable coding option, but I am open to other suggestions.
Scott Freathy, MD, CPC
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