# Laparoscopy and Laparotomy ileocolectomy



## Trendale (Jun 10, 2008)

Hi,
Do anyone know the appropriate way to code a Laparoscopy and Laparotomy ileocolectomy? The physician initialy started via the laparoscope, in which revealed a small abscess involving the abdominal wall, the remainder were found to have inflammatory adhesions involving loops of bowel in the pelvis. He was concerned that the patient had a inflammatory bowel disease, so at that point he elected to do a laparotomy, and so the laproscopic cannulas were removed and a vertical incision was made. At that point he could not tell if the process started off with a ruptered appendix versus inflammatory bowel disease, so he elected to resect the distal ileum and cecum. The specimen that likely include the appendix was sent to histopathology. The distal small bowel was placed side to side to the Rt of the colon and a functional end to end anastomosis was performed.

I have 49320 for the laproscopy, but I am not sure if this is bundled with the laparotomy and I am not certain of what code to use for the laprotomty ileocoletomy. The Dx is pelvic abscess. 

Thank you very much for your feed back.


----------



## Treetoad (Jun 10, 2008)

When a laparoscopic procedure is converted to an open procedure, you should only be coding the open procedure.  Also, you would want to add dx v6441 to the claim, which would indicate the conversion.


----------



## cmartin (Jun 17, 2008)

It's a 44160.
C.Martin, CPC-GENSG


----------

