A patient presented with a malignant neoplasm of the hepatic flexure of the colon and underwent laparoscopically-assisted right hemicolectomy. What is the correct code assignment for a laparoscopic-assisted right hemicolectomy? Should code V64.41, Laparoscopic surgical procedure converted to open procedure, be assigned as an additional diagnosis?
Assign code 45.73, Open and other right hemicolectomy, for the laparoscopic-assisted right hemicolectomy. Any right hemicolectomy that is not a true laparoscopic procedure is classified to this code since it includes "other" right hemicolectomy.
Code V64.41, Laparoscopic surgical procedure converted to open procedure, is not appropriate since this was a planned laparoscopic-assisted surgery. This case involved the planned use of the laparoscope to assist in visualizing and mobilizing the bowel. Once the bowel is mobilized, the incision can be extended in order to deliver the bowel. However, the incision would still be smaller than a traditional open right hemicolectomy. The fact that the surgery is done via a smaller incision can also assist in the patient's recovery. Some patients may experience less postoperative pain, thereby requiring less pain medication.