Digestive System

The codes in the digestive system subsection are used to report open, endoscopic,
and laparo�
scopic procedures performed on the mouth and related structures, the pharynx,
adenoids and
tonsils, esophagus, stomach, inte tines, appendix, rectum, anus, liver, biliary
tract, and pancreas.
The cod s are categorized first by body part involved and then by procedure, such
as herniorrha�
phy, esophagotomy, ileostomy, cholecystectomy, and hemorrhoidectomy. Figure 4.17
illustrates
the parts of the digestive system.

Laparoscopies

The digestive system subsection contains numerous laparoscopy codes that are
distributed
throughout the subsection based on various site-specific codes. When procedures are
per�
formed via laparoscopic approach, they must be distinguished from procedures
performed by
endoscope, open surgery, or percutaneous routes. A surgical laparoscopy always
includes a
diagnostic laparoscopy. When a procedure is started via a laparoscopic approach and
then con�
verted to an open procedure, the procedure should be thoroughly documented. CPT
Assistant
(March 2000) states that the open procedure should be reported with the attempted
laparoscopic
procedure, using the appropriate modifier.