tci General Surgery Coding Alert - 1999 Issue 1

Reader Question: Converting From Laparoscopic to Open Procedure

Question: The patient starts with a laparoscopic procedure for cholecystectomy, but after one hour, the procedure needs to be converted to an open procedure for completion. This could also apply to appendectomy. How do you code the procedure(s), do you use the same ICD-9 code, and do you use a modifier?James H. Risko, MDKnox Surgical Specialists, Mount Vernon, OHAnswer: The procedure should be coded 47600 (cholecystectomy) with a -22 (unusual procedural services,) attached, says Cindy Parman, CPC, of Coding Strategies, Inc., a Dallas, GA-based consulting firm.According to the General Coding Policies outlined in HCFAs National Correct...

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