You certainly could code it as 47100 with -52 modifier.
However, you should be able to defend your position on an unlisted code, as long as you equate it appropriately to the open procedure and price it correctly. I know it's a hassle, but we do have success with this.
Consider making these arranagments with the carriers IN ADVANCE. Get your physician to help you draft a letter explaining what the procedure entails and why you believe it should be reimbursed at "x" level. If you get the carrier's buy-in first, especially if it's for a procedure that you'll be doing with some regularity, that should serve you well.
F Tessa Bartels, CPC, CPC-E/M
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