# Colectomy with abscess drainage 49020-59  Bundled?



## Retrophaze (Jun 11, 2018)

So, doctors are on a 49020-59 roll and want it on all colectomy procedures that mention peritonitis, such as 44143 (Hartman's).  I specifically asked someone at a seminar this scenario and was told no:

If the doctor opens a patient and finds an abscess on one portion of intestine (say transverse), drains it,  and then performs a Hartman's (not involving the transverse), can we bill a 49020-59 with it? 

If the doctor opens a patient and finds pus and fecal matter in the abdomen due to perforation, drains it, and then performs a Hartman's, can we bill 49020-59?

I know my opinion/thoughts on it but don't want to sway anyone with them.


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## cpc2007 (Jun 22, 2018)

I would not unbundle 49020 in the scenarios you presented. 49020 is bundled to colectomy codes including 44143 as part of the "standards of medical/surgical practice." Because the edit has this reason attached to it, if the abscess drainage is required as a result of the same pathology happening in the colon and in the same general anatomic location (segment of the intestine being removed or alongside the intestine in the abdominal cavity as a result of the perforation), the abscess would be bundled as a routine part of performing the colectomy. 

If you have an abscess in a completely separate quadrant of the abdomen and that is drained for an unrelated reason (e.g., abscess drainage around the pancreas with a colectomy), I could support unbundling in that circumstance. I hope that helps .

Have a good night
Kim
www.codingmastery.com


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