# Ruptured Appendix w/ Abscess



## FTessaBartels (Dec 13, 2011)

We're having some back-and-forth on this one.

Patient has a ruptured appendix w/ abcess (and fecal material in the peritoneal cavity).
Approach is *laparoscopy*.

Do you code 44960 
Do you code 44970 [22]
Do you code 44979 and base you fee on 44960?

I'd appreciate your thoughts and why.  I could argue for each of these options. 

F Tessa Bartels, CPC, CEMC


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## Grintwig (Dec 13, 2011)

I would go with 44979 because the procedure was performed laparoscopically and there is an unlisted lap code for appendix. 
And I too would base my charges on the charge for the open code for this procedure 44960. I would do so because the procedure required more work than the description for 44970 entails and 44960 is a the closest representation of the work actually done.


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## colorectal surgeon (Dec 13, 2011)

I would agree with McCormick. Sounds like an unlisted code.


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## Lujanwj (Dec 14, 2011)

Why not 44970-22?  Code is not limited by it's description.  At the core of the procedure the Dr is doing an appendectomy.  Yes, it might have an abscess or might have even ruptured but it's still an appendectomy.  Unfortunately, the values between 44960 and 44970 are horrible but from a coding stand point I can't worry about that. 

Any clarification to why the unlisted would be greatly appreciated.  I've seen this a few times in our office and our compliance dept says 44970-22.


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## colorectal surgeon (Dec 14, 2011)

The more I think about it I would just do 44970-22.


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