# Diagnostic Lap with Graham's patch - duodenal perforatios



## Trendale (Jul 22, 2009)

Hello,
Please help with the following PX:

The physician did a diagnostic Lap with Graham's patch( a surgical techinque that is used to close duodenal perforatios. A piece of omentum is used to cover the perforation). DX: peritonitis secondary to anastomitic leak

The patient just had bariatric surgery 24 hours prior. The only code I found was 49329 unlisted.

49329-78 
1.997.4 
2.567.9

Is any of those codes correct?


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## LTibbetts (Jul 22, 2009)

the CPT 49326 looks like a good one to use but it is an add-on code for 49324 or 49325 and neither of those look good so my next guess would be the unlisted code you chose.


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## Trendale (Jul 23, 2009)

*Reply*

Thanks!


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## iluvicd9 (Jul 28, 2009)

*Graham Patch*

We use 43659 for a lap Graham Patch.


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## vikas.maheshwari (Jul 28, 2009)

i think 44799 is the perfect choice for this procedure as far 43659 concern it is a laparoscopic procedure so you cannot bill this until the procedure did not mention laparocopic.


Thanks,

Vikas Maheshwari
MBA-HCS, CPC-H
vikashmaheshwari@gmail.com


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## billing@austinelevate.com (Feb 19, 2013)

You should use code 49329 "Unlisted laparoscopy procedure, abdomen,peritoneum and omentum." This is a more definite code for the omental patch.


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