# Small bowel obstruction?



## hsmith67 (Jun 14, 2011)

Please help - exploratory laparatomy for small bowel obstruction. Lysis of adhesion associated with open cholecystectomy done in 1984. Now, quoting from op note referring to adhesions:
"These adhesions were lysed with the Bovie cautery and there was a loop of bowel that was twisted on itself creating an internal hernia and creating a functional mechanical obstruction. This bowel was untwisted. It was found to be viable and pinked up following placement of a warm moist rag on the bowel."

So....I am looking to bill the exploratory laparatomy and lysis of adhesions. However, is there anything at all I can/should bill for the manual manipulation of the bowel to untangle the twisting on itself? 

49000 Dx 560.9
44180 Dx 560.9

Anything else to bill? 
Thanks for any help anyone can provide.
Hunter Smith, CPC


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## colorectal surgeon (Jun 14, 2011)

44005 is all I would bill


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## dadhich.girish (Jun 14, 2011)

Agree with 44005 only.


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## hsmith67 (Jun 15, 2011)

*ok....*

So don't bill the 49000? The only code I bill is 44005?

Thanks, 
Hunter


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## hsmith67 (Jun 15, 2011)

*Never mind..*

I see that 49000 is defined as a  "Separate procedure" -my mistake. I see your point, thanks for the feedback.

Hunter Smith, CPC


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## NaliniAAPC (Jun 15, 2011)

Hi,
Yes its 44005 only...

Nalini CPC


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