# Perforated appendix and removal of cecum



## Mklaubauf (Jul 14, 2009)

Hi,
If we remove a perforated appendix (44960) and remove 6-8" of the cecum (44160) can we bill these both together. 
They do not bump up against each other on CCI edits.   I'm not finding any articles on this.  

Marci Klaubauf


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## mjewett (Jul 14, 2009)

Code 44160 includes removing the appendix. You should only bill 44160.


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## LTibbetts (Jul 16, 2009)

Is that somewhere in writing? I can't seem to find that documented anywhere and I am very interested in that particular area.  Do you know where I can find anything about it?


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## mjewett (Jul 16, 2009)

Look at the illustrations in the front of the CPT book for the Digestive System, the Appendix is attached only to the cecum, if the cecum is removed the appendix would have to be removed too.

I also checked the NCCI edits on the cms website. Code 44160 and 44950 are listed together with the status indicator (0) 

Hope this helps.


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## Mklaubauf (Jul 16, 2009)

Melissa,
Thank you for your input.  The codes I have are 44960 not 44950 and 44160.  They do not bundled together.  Does that matter.  I do realize that if we went in to remove part of the lower colon and took the appendix  because it looked abnormal, we would not charge for the appendix.   Does it make a difference because we went in only to take care of the ruptured appendix and had to take some of the cecum because it was so necrotic.  
Thank you again for your input.
Marci Klaubauf, CPC


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## mjewett (Jul 17, 2009)

Marci,
Ok you got me stumped, your right, code 44960 and 44160 are not bundled. Hmmmm... I tried to looking to see if the appendectomy code includes removing a small part of the cecum, but could not find any documentation.  My gut opinion is bill only 44160, but I am curious now too.


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## Mklaubauf (Jul 20, 2009)

Hi Melissa,
I was getting different information, so I called the American College of Surgeons Coding @1-800-227-7911 they have a coding hotline.
I spoke w/ a gal named Karen and she said to bill both
44160
44960-51

Hope that helps,
Marci Klaubauf, CPC


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## LTibbetts (Jul 21, 2009)

Good to know!! Thanks for sharing that info, Marci!!


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## mjewett (Jul 23, 2009)

Thanks for the info. I will definitely keep that number on file.


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