tci General Surgery Coding Alert - 2003 Issue 3

Reader Question: When Converting, Report Only the Open Procedure

Question: How should I code if the surgeon must convert to an open procedure during laparoscopic cholecystectomy? A substantial portion of the work was completed laparoscopically before the conversion. New York SubscriberAnswer: CPT does not provide instruction on this situation, but Medicare guidelines dictate that you may report only the open procedure, regardless of how much of the procedure the surgeon completed laparoscopically. Specifically, instructions provided in the introductory portion of the national Correct Coding Initiative (CCI) state, "When an endoscopic service is attempted and fails and another surgical service is necessary, only the successful service is reported" [emphasis...

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