# Debulking of pseudomyxoma peritonei



## Tammy Hale (Dec 5, 2008)

Hello. I have another stumper. I could not find any code for this procedure. The dictation states "the rest of the abdomen was filled with muci. We scooped as much muci out as we could and debrided some of the abdominal wall infiltration. We could not run the entire bowel given the severity and we could not take down her ostomy. Once we evacuated as much mucin as we could we made a decision to close her abdomen." 

How do I code debulking?

What does it mean that we could not take down her ostomy? 

I am still new in coding and really appreciate any help. Thanks again. 

Tammy


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## lavanyamohan (Dec 6, 2008)

Hello,
It could be abscess treatment-
Drainage of abdominal abscess- CPT:49020
But says ostomy left out;
Got to give 52 modifier, I feel; Please check-


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## mkj2486 (Dec 7, 2008)

It appears that pseudomyxoma peritonei involves a secondary malignancy and has nothing to do with an abcess.  I was researching this, and all I could find on debulking surgeries involve the reproductive orgrans.  So I couldn't come up with a definitive CPT code for the procedure, and I am thinking you may have to use the unlisted code, 49999.  As far as not being able to take down the ostomy, Ito me,  that means the patient had a stoma of some sort (colostomy, etc.) and the original intent was to close this.  However, due to the fact the patient had the pseudomyxoma peritonei, this was not possible.


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## Tammy Hale (Dec 9, 2008)

*Thank you.*

Thank you Networker and Guru for help with the debulking issue. I believe it would probably be an unlisted procedure. Again thanks for your help. 

Have a great day! 

Tammy


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## garmab06 (Dec 10, 2008)

Check new codes for 2008 series  49203 - 49205 debulking, resection 
Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less 
hope it helps
L.IvonneGarcia CPC


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