Hasson technique in laparoscopic surgery

mike4dawn@yahoo.com

I am an inpatient CDI. I took a laparoscopic cholecystectomy to a laparoscopic procedure; however, the coder took it to open based on the operative note mentioning the use of a Hasson trocar. She referenced a coding clinic 4Q 2011 pg 4. Most of our laparoscopic surgeries will mention a Hasson trocar use. I am questioning the correct coding of these procedures-open vs laparoscopic. thanks

sherisimoni@comcast.net

I am unable to locate the Coding Clinic referenced. It's likely the advice may not apply to ICD-10-PCS or the approach definitions. The definition of a Percutaneous Endoscopic approach is, Entry by puncture or minor incision, of instrumentation through the skin or mucous membrane and/or any other body layers necessary to reach and visualize the site of the procedure (Laparoscopic). If all of the work to perform the procedure was done with the laparoscope, then the approach is Percutaneous Endoscopic. An open approach exposes the site of the procedure for direct visualization by the surgeon. The Hasson technique in laparoscopic surgery is and open method of port (trocar) insertion followed by rapid pneumoperitoneum rather than blind insertion of the Veress needle and first trocar. The Hasson technique is a percutaneous endoscopic approach which includes entry by minor incision of instrumentation per the ICD-10-PCS definition.

mike4dawn@yahoo.com

thank you