tci General Surgery Coding Alert - 2012 Issue 10

Reader Question: Modifier, Not Code, May Capture Take-Down

Question: What is appropriate CPT®code for mobilization of splenic flexure in addition to laparoscopic transverse loop colostomy (we can't use +44213 because it is limited to use with 44204-44208)?Ohio SubscriberAnswer: There is no way to separately code for the splenic flexure mobilization in addition to the laparoscopic transverse loop colostomy. The take-down is included in the colostomy because it's a customary integral part of the procedure, especially for left-sided colostomies, which are more common. If the physician documents that the take-down involves significant additional work, then you can append modifier 22 (Increased procedural services) to the procedure...

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