A surgeon began a laparoscopic procedure and after lysis of dense adhesions had to convert to an open Hartmann procedure and open mobilization of the splenic flexure. How do I report this?
Answer:
The appropriate CPT codes based on the information provided in your inquiry are:
44143 Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure)
44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)
If the surgeon’s documentation indicates significant additional work or time due to the initiation of the procedure laparoscopically and then conversion to an open, the use of modifier 22, Increased Procedural Service may be warranted. Add the diagnosis code for conversion of a laparoscopic procedure to an open as the last diagnosis code for each procedure: V64.41 Laparoscopic surgical procedure converted to open procedure.
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