tci General Surgery Coding Alert - 2001 Issue 4

Three Tips Help Optimize Billing for Laparoscopic Cholecystectomy

In some situations, a general surgeon may receive additional reimbursement for a laparoscopic cholecystectomy (lap chole). For example: If significant additional work or time is required to lyse adhesions, repair a complication or convert the procedure from laparoscopic to open, modifier -22 (unusual procedural services) can be appended to the appropriate code and additional payment claimed; or If the surgeon performs a cholangiogram with no radiologist present and provides the supervision and interpretation (S&I). Additionally, by carefully reviewing the surgeons procedure notes, coders may uncover additional payment opportunities. For example, cholangiograms are frequently performed in conjunction with cholecystectomies...

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