# Bowel mass?  Need help



## Rgreen0118 (Mar 15, 2011)

Not sure how to code this one:  A little of my OBGYN league.......Can anyone help with this?

diagnostic laparoscopy, pelvic adhesions = 49320

Op note reads:
Bullet nose graspers and cautery scissors used to take down the left sided pelvic adhesions and "remove the large - bowel cystic mass?"

How do you code the excision of the bowel mass?  Should I just add a 22 modifier?

Thanks in advance! 
__________________
Rhonda Green, CPC


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## Faizia Khan (Mar 31, 2011)

How about 44110-22 (excision of 1 or more lesion of small/large intestine not requiring anastomosis, exteriorization/fistulization; single enterotomy) ?


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## cmartin (Apr 4, 2011)

Sounds like it may be an unlisted laparoscopic procedure, intestine (44238). (Lap lysis of intestinal adhesions is 44180, but it sounds like the main thing here was the excision of a cystic mass from the large bowel?)


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## colorectal surgeon (Apr 8, 2011)

how about

49203.	 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	

49204.	 Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter	

49205.	 Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter


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## surgonc87 (Apr 11, 2011)

49321 Laparoscopy, surigical; with biopsy (single or multiple)

They dont know what that mass is yet, so this code best reports it laparoscopy.

MS


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