South African Medical Association

The use of item 2493 - Diagnostic Laparoscopy and item 1807 - Procedure performed laparoscopically - ADD to item for 'open' procedure

The SAMA Private Practice Department is inundated with calls from doctor's rooms regarding the usage of items 2493 and 1807. The common complaint is that medical schemes are rejecting accounts that use one or both of these 2 items with other procedures. It has become apparent to us that some of these items are used incorrectly. To assist our members we have attached the guidelines for these items below:

Item 2493

Description

Diagnostic laparoscopy (excluding after-care)

Interpretations

Appropriate for both male and female patients
Item 2493 and item 1807 may not be used together
No post-operative consultation fees are applicable in cases where diagnostic and therapeutic procedures were performed concurrently e.g. item 2493 (laparoscopy) with item 2501 (cauterisation and/or lysis of adhesions) plus D & C

Item 1807

Description

ADD to open procedures where procedures was performed through a laparoscope or transanal endoscopic operations (TEO) (for anaesthetic refer to modifier 0027)

Interpretations

Refer to modifier 0027 for anaesthetic
Not to be added to item 2493: Laparoscopy

Additional Information

Item 2493 may only be used in conjunction with items 2496-2505 ('+' items).

When only a diagnostic laparoscopy is performed and is not followed by a procedure, item 2493 is appropriate.

When a diagnostic laparoscopy is followed by the indicated laparoscopic procedure, item 1807 and not item 2493 must be used.

When performing laparoscopic procedure, please check first whether a dedicated item for this procedure does not appear in the Medical Doctors Coding Manual (MDCM).

When an unsuccessful laparoscopic procedure is followed by an 'open' procedure, neither item 2493 or 1807 may be added to the appropriate procedure code.

The use of item 2493

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