June 01, 2012
Area(s) of Interest: Payor Issues and Reimbursement Practice Management
CPR’s “Coding Corner” focuses on coding, compliance, and documentation issues relating specifically to physician billing. This month’s tip comes from the Vice President of ICD-10 Training and Education for the American Academy of Professional Coders (AAPC), Rhonda Buckholtz, CPC, CPMA, CPCI.
A commonly asked current procedural terminology (CPT) coding question involves the use of robotic assistance during a procedure. The main questions are how do we bill and will we be reimbursed for it?
For example, a surgeon performs a robotic-assisted repair of paraesophageal hernia with mesh. The documentation of a robotic-assisted procedure is very similar to a laparoscopic procedure; the patient’s abdomen is inflated after trocars are inserted. Where the procedures differ is that during a laparoscopic procedure the surgeon would be at the operating table, and in a robotic surgery the surgeon is at the controls of the robot.
The coding is assigned using the laparoscopic codes, in the example above it would be code 43282; laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed, with implantation of mesh.
To report the use of the robot assist use HCPCs code S2900, surgical techniques requiring use of robotic surgical system. The reporting of this code is purely informational and will not be reimbursed by payers. Coder’s should report all appropriate codes regardless if reimbursement is attached to the codes or not.