Anesthesia Coding Alert

Question: Which CPT Codes and anesthesia codes apply to the repair of diastasis recti?


Utah Subscriber

Answer: You have two surgical code options for this service, depending on whether the procedure was intraperitoneal: 22999 (Unlisted procedure, abdomen, musculoskeletal system) and 49999 (Unlisted procedure, abdomen, peritoneum and omentum).

Procedure code 22999 crosses to either anesthesia code 00700 (Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified) or 00800 (Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified). Check the chart notes to determine which code to use based on the repair location.

Procedure 49999 crosses to anesthesia code 00790 (Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified) or 00840 (Anesthesia for intraperitoneal procedures in the lower abdomen including laparoscopy; not otherwise specified). Again, this depends on the surgical location.

Remember: Always include reports with your claim when you submit -unlisted-procedure- codes to help explain the anesthesiologist's service.Two of the anesthesia code options (00700 and 00800) each have four base units. Codes 00790 and 00840 each have seven base units to reflect the increased difficulty of an intraperitoneal procedure.

Diastasis recti abdominus is the separation of the two rectus muscles along the median (middle) line of the abdominal wall. When the surgeon performs this repair on an infant, the separation typically results from incomplete development, so insurance generally covers it. In an adult woman, however, the abnormality is typically related to pregnancy. Some carriers consider the repair to be cosmetic, which means they might not cover it.