tci General Surgery Coding Alert - 2008 Issue 7

Reader Questions: Surgical Service Includes Visualization

Question: Our surgeon performed an exploratory laparoscopy followed by an open cholecystectomy. I know that a diagnostic endoscopic procedure is included in a surgical endoscopic procedure, but does the same logic hold when the surgeon performs an open procedure? Arizona Subscriber Answer: If the surgeon performs either a laparoscopic or open surgical procedure subsequent to visualizing the area laparoscopically, you should include the diagnostic scope in the surgical procedure. National Correct Coding Initiative (CCI) guidelines address this issue specifically: "An open cholecystectomy [47600] includes an examination of the abdomen through the abdominal wall incision. If this examination is performed...

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