Forum - Questions & Answers

Sep 1st, 2022 - aolsen7777

Esophagectomy with prophy Thoracic Duct Ligation

hi,Does anyone know if we can code 43118 and 38381?  The surgeon did a prophy ligation of thoracic duct with his esophagectomy.Thank you

Sep 6th, 2022 - ChrisW   256  1 

re: Esophagectomy with prophy Thoracic Duct Ligation

Yes, these procedures can be reported together, as the primary procedure (43118 - Partial esophagectomy, distal two-thirds, with thoracotomy) includes a thoracotomy and the ligation is a thoracic approach, requiring a thoracotomy. The multiple procedure payment adjustment will apply as there is a status indicator “2” on both procedures indicating:
Multiple Procedures (51): 2
Standard payment adjustment rules for multiple procedures apply. If a procedure is reported on the same day as another procedure with an indicator of 1, 2, or 3, rank the procedures by fee schedule amount and apply the appropriate reduction to this code (100%, 50%, 50%, 50%, 50% and by report). Base the payment on the lower of (a) the actual charge or (b) the fee schedule amount reduced by the appropriate percentage.
Always consult with your payer to confirm their coding requirements. 

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