tci General Surgery Coding Alert - 2008 Issue 6

You Be the Coder: Can Chole Be Separate With Whipple?

Question: Can we report a cholecystectomy at the same time as a whipple procedure if the reason for the chole is chronic inflammation or sludge? I have reported these procedures together with modifier 59, but Medicare denied the claim. Washington,D.C.,SubscriberAnswer: A standard radical pancreaticoduodenectomy, or Whipple procedure (48150, Pancreat-ectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy [Whipple-type procedure]; with pancreatojejunostomy), typically includes removal of the gallbladder and ligature of the cystic duct. Sludge is not usually a priority when a patient requires a Whipple, and your surgeon probably didn't remove the gallbladder for...

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