Why you can't bill a lap and an open together

Why This Topic Matters

Understanding this guidance helps prevent improper duplicate reporting when different surgical approaches are used for the same procedure during one encounter. It is relevant to compliance, claim accuracy, and avoiding denials or recoupment issues.

Article Sections

1. Why you can’t bill a lap and an open together

   Introduces the topic and frames the article around reporting procedures involving laparoscopic and open approaches in the same encounter.

2. Medicare guidance from the MCM, Section 15068

   Summarizes Medicare policy language addressing procedures that are similar, performed on the same site, or involve sequential approaches.

3. Correct Coding Initiative guidance

   Presents general CCI policy on reporting multiple methods of accomplishing a procedure and related approach selection considerations.