What does Separate Procedure mean?

[Jack Kline]

Please explain "separate procedure" in plain English. Thank you!

 

[Ruth Sheets]

In my Carol S. Buck, 2012 Medical Coding book, the glossary definition is this:

Separate procedures: minor procedures that when done by themselves are coded as a procedure, but when performed at the same time as a major procedure are considered incidental and not coded separately.

Not sure that was plain English.

For example, 49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). If the person goes in for this procedure and has nothing else done then you can code it, because it is a separate procedure. If a person goes in for the 49320 laporoscopy and also has and unrelated surgery done, say a bunion repair, then you can code it, because the lapaoscopy is a separate procedure. But if the person has a 49320 laporoscopy and in the same surgical session that precedes a repair to the abdomen then you can't code the 49320 laporoscopy because it is not separate, but included in the repair.

This mystified me for the longest time, so I liked that you asked your question because I had the same one when I was a student.

 

[Ruth Sheets]

Laureen Jandroep covered this topic in the May 2015 Q&A Webinar. She explained the "separate procedure" is a convention used in CPT to designate procedures that are often times included in other larger procedures. It should remind us as coders to make sure it is not already bundled in another code we are reporting. She went on to show using a CCI edit checker on findacode.com to see if one code is bundled in another.
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