Results 1 to 5 of 5

Open code vs lap unlisted code

  1. #1
    Johnson City
    Default Open code vs lap unlisted code
    Medical Coding Books
    I am wondering what the consensus is on this situation. I often can not find the laparoscopic code that I'm looking for and often have to opt for an unlisted. Example: Surgeon performs laparoscopic liver biospy wedge. The only code for wedge biopsy of the liver is code 47100, which is open. The codes for Laparoscopic liver bx do not accurately describe a wedge bx. therefore code 47379 is my option. I prefer not to use unlisted codes, carriers do not price appropriately, and the delay in processing of the claim is annoying. I heard that some coders choose to bill the open code with mod 52indicating this procedure is reduced. ie. not open, laparoscopic. What do you think about this practice.

  2. #2
    Milwaukee WI
    Default 47100 -52
    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
    Last edited by FTessaBartels; 02-16-2009 at 02:48 PM.

  3. #3
    Johnson City

  4. #4
    What if the physician performs a core needle biopsy during a lap chole but he makes a separate abdominal incision to place the biopsy needle through? Could we code this as 47000-59 or stay with +47001?

    Mary Beth Gord, CPC

  5. #5
    47001 is an add on code to hundreds of lap codes, including 47562/47563. I have previously posted the list under one of the forums (dont ask me which but its here somewhere

    Mary, CPC,COSC

Similar Threads

  1. Hernia code 49653, ASA lap code
    By kdavis169 in forum Anesthesia
    Replies: 2
    Last Post: 04-21-2015, 10:20 AM
  2. Unlisted Code
    By JCampbell in forum General Surgery
    Replies: 2
    Last Post: 09-07-2012, 12:16 PM
  3. Unlisted code vs Open Procedure Code
    By christinnagle in forum Orthopaedics
    Replies: 1
    Last Post: 03-30-2011, 12:06 PM
  4. Unlisted laparoscopic stomach code with unlisted omentum code
    By graciejean in forum General Surgery
    Replies: 0
    Last Post: 08-20-2010, 06:30 AM
  5. Replies: 1
    Last Post: 08-05-2008, 03:17 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.