There is only one robotic CPT code for a prostatectomy in the CPT book and that code reads: 55866- Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance when preformed.
The Health Care Common Procedure Coding System (HCPCS) code S2900 (Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)) describes a computer-aided tool used in performing a specifi c surgical procedure. UnitedHealthcare Community Plan considers S2900 not separately reimbursable.
Robotic is S2900 I agree with that for robotic assistance the correct code is S2900. And that carriers generally don't pay for it. We were able to get 1 carrier to put it into our contract to pay for that code.
robotic surgery increases surgeons’ control, with laparoscopic surgery, each hand controls one instrument or the camera (a total of two items), with robotic surgery, the surgeon controls all camera movements and three instruments (four items), the robotic instruments move smaller distances in the body than the hand controls move at the surgeon’s …
The code for a total abdominal hysterectomy is: 0UT90ZZ Resection of uterus, open approach. In this example the “Z No Qualifier” is indicating that both the uterus and cervix are removed. The code for a laparoscopic supracervical hysterectomy is: 0UT94ZL Resection of uterus, percutaneous endoscopic, supracervical.
ICD-10-PCS Draft Coding Guideline B5. 2 states that procedures performed via natural or artificial opening with percutaneous endoscopic assistance are coded to approach value F. The code for a laparoscopic-assisted total vaginal hysterectomy is 0UT9FZZ, with the fifth character value of F.
When coding for laparoscopic or robotic procedures, code the standard laparoscopic CPT code, example 58552 for a laparoscopic or robotic vaginal hysterectomy, for uterus 250 g. or less with removal of tube(s) and ovary(s) or as another example 58571 laparoscopic or robot- ic total hysterectomy for uterus 250 g. or less ...
Z90. 710 - Acquired absence of both cervix and uterus | ICD-10-CM.
Examples include knee arthroscopy and laparoscopic cholecystectomy. This approach includes procedures whereby the procedure is performed entirely by percutaneous endoscopic approach. Percutaneous endoscopic-assisted procedures are coded to the open approach as stated above.
0FT44ZZLaparoscopic. As shown in Figure G, the valid code for laparoscopic cholecystectomy is 0FT44ZZ.
The Health Care Common Procedure Coding System (HCPCS) code S2900 (Surgical techniques requiring use of robotic surgical system (list separately in addition to code for primary procedure)) describes a computer-aided tool used in performing a specific surgical procedure.
By definition, in TLH, total uterine removal is performed laparoscopically; LAVH implies performing laparoscopic removal above the uter- ine vessels, which are secured during the vaginal phase. Both TLH and LAVH are associated with many advan- tages over total abdominal hysterectomy (TAH).
If you perform a laparoscopic hysterectomy, BSO, debulking, the proper CPT code would be 58575 (Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed).
A total abdominal hysterectomy with a bilateral salpingo-oophorectomy (TAH-BSO) requires four codes in ICD-10-PCS because of the specificity of the body part values.” Should say “A total abdominal hysterectomy with a bilateral salpingo-oophorectomy (TAH-BSO) requires three codes in ICD-10-PCS.
CPT® Code 58150 in section: Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)
722.
CPT® 58661, Under Laparoscopic Procedures on the Oviduct/Ovary. The Current Procedural Terminology (CPT®) code 58661 as maintained by American Medical Association, is a medical procedural code under the range - Laparoscopic Procedures on the Oviduct/Ovary.
CPT® Code 58573 in section: Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g.
CPT® Code 58571 in section: Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less.
CPT® Code 58552 in section: Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less.
The ICD-10-PCS code assignment for this example is: 1 0UT90ZZ, Resection of uterus, open approach (for the hysterectomy) 2 0UTC0ZZ, Resection of cervix, open approach (for removal of the cervix) 3 0UJD4ZZ, Inspection of uterus and cervix, percutaneous endoscopic approach (for the attempted laparoscopic hysterectomy) 4 8E0W4CZ, Robotic assisted procedure of trunk region, percutaneous endoscopic approach (for the attempted robotic-assisted surgery)
ICD-10-PCS codes 0UT90ZZ and 0UTC0ZZ are assigned based on the following Character 3 root operation coding guidelines and advice for this procedure: Medical and Surgical Section of the 2015 ICD-10-PCS Official Guidelines for Coding and Reporting:
In ICD-10-PCS, procedure codes consist of a seven character code structure, with each character code including specific values. ICD-10-PCS coding is applied at the procedure document type level where a code is assigned based on specific values for each of the seven characters (see Figure 1 above).
The American Hospital Association’s (AHA’s) Coding Clinic indicates when the provider’s operative note documentation does not specify the end placement of the infusion device, the imaging report may be used to identify the required body part for the ICD-10-PCS code assignment. This scenario illustrates how the use of two procedure document types provide all the required documentation necessary for the accurate ICD-10-PCS code assignment and emphasizes the need for facilities to define all the appropriate procedure document types for ICD-10-PCS coding.
IN THIS ARTICLE, the Journal of AHIMA continues its three-part Coding Notes series focusing on the nine Medical and Surgical-related sections of ICD-10-PCS. This article will take a more in-depth look at the last three of these nine sections:
The Osteopathic section is one of the smallest sections in ICD-10-PCS with only a single body system, Anatomic Regions, and a single root operation, Treatment.
The Alphabetic Index main term entry is Replacement, subterm knee which identifies code 81.54. Code 81.54 is assigned for a total knee replacement, bicompartmental replacement, partial knee replacement, tricompartmental replacement, or unicompartmental (hemijoint) replacement. ICD-9-CM does not differentiate laterality, so code 81.54 is assigned whether this procedure is performed on the left or right knee. The Alphabetic Index main term entry is Surgery, subterm, Computer-assisted which identifies code 00.39.
The root operation for the computer assistance is Other Procedures with the assignment of code 8E0YXBZ. The sixth character value of B identifies that the method of the procedure was via computer assistance.
The seven characters in the Other Procedures section are shown in Figure 2 below.
The Other Procedures section contains codes for procedures not included in the other Medical and Surgical-related sections of ICD-10-PCS. There are relatively few procedures coded in this section. The add-on codes for robotic-assisted and computer-assisted procedures are located in this section. Whole-body therapies including acupuncture and meditation are also included in this section along with a code for the fertilization portion of an in vitro fertilization procedure.
Manual procedures that involve a direct thrust to move a joint past the physiological range of motion, without exceeding the anatomical limit
ICD-10-PCS Draft Coding Guideline B5.4a states that procedures performed via an indwelling device are coded to approach value 3, percutaneous. Fragmentation of kidney stone performed via percutaneous nephrostomy illustrates the use of this guideline, and the approach value for this procedure is 3.
In contrast, a D&C performed with the use of a hysteroscope would be coded to 0UDB8ZZ, as visualization instrumentation (hysteroscope) was used to reach the site of the procedure.
The ICD-10-PCS code for a diagnostic percutaneous paracentesis for ascites is 0W9G3ZX, with the fifth character (3) indicating a percutaneous approach. During this procedure a small incision is made and a needle or catheter is inserted into the peritoneal cavity to obtain ascitic fluid. Another example would be a PTCA of the right coronary artery with the insertion of a stent, which codes to 02703DZ.
An endoscopic retrograde cholangiopancreatography with lithotripsy of the common bile duct (code 0FF98ZZ) is performed via a scope (visualization instrumentation) entering through the mouth (natural opening) for access to the biliary system via the duodenum. Therefore, the approach value is 8.
The ICD-10-PCS code for a laparotomy with removal of the gallbladder is 0FT40ZZ, with the fifth character of the code (0) indicating that the procedure was performed via an open approach. During this procedure an incision is made through the abdominal wall (laparotomy) to remove the gallbladder.
Another example of an open approach is an abdominal hysterectomy with a Tru-Cut needle biopsy of the left lobe of the liver. During this procedure a Pfannenstiel incision is made, the abdominal cavity is opened and explored, and a needle biopsy is performed. Subsequently the uterus is also removed.
One of ICD-10-PCS’s goals is to ensure a complete picture of a patient’s procedure. Completeness means that there is a unique code for all substantially different procedures, including the same procedure performed using a different approach.
In the article “ Pinpoint Correct Hysterectomy Coding ” (August 2018, pages 16-18), the statement, “… a laparoscopic-assisted vaginal approach — a ‘subset’ of the vaginal approach — in which a scope is inserted via small incisions in the vagina,” is incorrect, and is not the basis for coding a laparoscopically assisted vaginal hysterectomy (LAVH) versus a total laparoscopic hysterectomy (TLH)..
Code selection for a TLH versus a LAVH depends on how the uterine cervix and body are detached from the supporting structures.
Consider the following chart example: The patient was taken to the OR, where her anesthetic was induced. She was then placed in the dorsal lithotomy position and underwent examination under anesthesia. She was then prepped and draped in the usual manner for vaginal and abdominal surgery.
HCPCS code S2900 – Surgical techniques requiring use of robotic surgical system (listed separately in addition to code for primary procedure), was effective July 2005 and can be used by your hospital to report the use of robotic assistance. However, it is a non-reimbursable code under Medicare and may not be recognized as a separately billable and payable service by a majority of leading commercial payers
Robotic-assisted surgery refers to technology that allows the surgeon to operate from a console, remote from the patient and not in sterility. Many hospitals have adopted this technology in the fields of: Urology, Gynecology (Oncology, Urogynecology and General Gynecology), and Colorectal Surgery.
Providers need to be aware that, since there are no unique codes for robotic procedures, the additional time and effort that is spent setting up, docking and un-docking the robot are not reimbursed additionally.
In CPT 2008, the American Medical Association (AMA) published the total laparoscopic hysterectomy (TLH) set of codes (58570-58573). This, in addition to the laparoscopic radical hysterectomy with pelvic lymphadenectomy code (58548), is the third set of CPT codes addressing the laparoscopic approach to hysterectomy.
LSH includes laparoscopically detaching the body of the uterus down to the uterine arteries. The uterine body is then separated from the cervix, hemostasis of the cervical stump is achieved, and the endocervical canal is coagulated. The uterine body is then abdominally removed by bivalving, coring, or morcellating, as required. ...
Example: Laparoscopic-assisted sigmoidectomy is coded to the approach Open.
Procedures performed percutaneously via a device placed for the procedure are coded to the approach Percutaneous.
Examples of Percutaneous Procedures: -Percutaneous chest tube placement for right pneumothorax. -needle biopsy of liver . -liposuction.
Example: Resection of tonsils is coded to the approach External.
Example: Closed reduction of fracture is coded to the approach External.
Endoscopic means allows visualization. External (X) Procedures performed DIRECTLY on the skin or mucous membrane and procedures performed indirectly by the application of external force through skin or mucous membrane. Examples of External Procedures: