# Diag.Laparoscopy/Laparotomy



## Hopp (Jul 2, 2008)

Hi everyone!   Please help with the following?  Doc performs a diagnostic laparoscopy and encounters bowel problems adhesions.  He now does decompresses and does a laparotomy, lysis of adhesions and an incidental appendectomy (Path:normal appendix).   Would I code the lysis of adhesions?
Thanks in advance for helping with this?  In addition he did a biopsy of a messenteric nodule - I don't think I can bill this as stated in the CPT book - separate procedure am I correct?


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## amitjoshi4 (Jul 3, 2008)

49000 is the code to be used here. In performing Laparotomy, lysis of adhesions is inclusive.

Thank You


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## mmelcam (Jul 3, 2008)

I would use 44005 and use V64.41 as one of your secondary diagnosis codes.


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## Treetoad (Jul 3, 2008)

I agree with Melissa.  If adhesiolysis is performed, it's no longer an exploratory laparotomy.


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## dmaec (Jul 3, 2008)

I also agree with Melissa and Treetoad - If adhesiolysis is performed, it's no longer an exploratory laparotomy.
Donna


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## Belinda Frisch (Jul 10, 2008)

Hopp said:


> Hi everyone!   Please help with the following?  Doc performs a diagnostic laparoscopy and encounters bowel problems adhesions.  He now does decompresses and does a laparotomy, lysis of adhesions and an incidental appendectomy (Path:normal appendix).   Would I code the lysis of adhesions?
> Thanks in advance for helping with this?  In addition he did a biopsy of a messenteric nodule - I don't think I can bill this as stated in the CPT book - separate procedure am I correct?



I would definitely agree, 44005 would be the way to go. If the patient has an obstruction secondary to adhesions (such as a SBO) I would use ICD-9 code 560.81 "adhesions, intestine, with obstruction". An exploratory lap does not include LOA.


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## viborges (Jun 7, 2011)

*Need code*

CODING FOR EXPLORATORY LAPAROSCOPY FOLLOWED BY LAPAROTOMY, LYSIS OF ADHESION'SQJhx54&$Q3qSMJ5 AND REPAIR OF GASTRIC PERFORATION.
Anyone know the code for this, doctor says to use 43840 with dx of 8630 and mod 79(this is a return)
thanks


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## surgonc87 (Jun 8, 2011)

viborges said:


> CODING FOR EXPLORATORY LAPAROSCOPY FOLLOWED BY LAPAROTOMY, LYSIS OF ADHESION'SQJhx54&$Q3qSMJ5 AND REPAIR OF GASTRIC PERFORATION.
> Anyone know the code for this, doctor says to use 43840 with dx of 8630 and mod 79(this is a return)
> thanks



If the perforation was ensued by the LOA, then its a no go. Just report the LOA in that case. Otherwise if exploration was done, and perforation was there as a result of something else, the code 43840 by all means.


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