Gastroenterology Coding Alert

Question:  I know that some anesthesia codes are applied based on whether the area treated was the upper or lower abdomen. How do I know which are the correct anesthesia codes for upper and lower abdominal intraperitoneal procedures?

North Carolina Subscriber

Answer: The patient’s belly button is the dividing line between upper and lower code choices. If the surgery is on an organ that is internally below the belly button, it’s a lower abdominal procedure and is coded with 00840 (Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified). If the surgery site is above the belly button, consider it an upper abdominal procedure and report 00790 (Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified).

You should also be familiar with what constitutes intraperitoneal and extraperitoneal classifications:

• Intraperitoneal: Within the peritoneal cavity and including the stomach, liver, gallbladder, spleen, jejunum, ascending and transverse colon, appendix, cecum, ileum, and sigmoid colon
• Extraperitoneal: Outside or behind the peritoneum and including the ureter, urinary bladder, kidneys, adrenal glands, lower esophagus, aorta, and inferior vena cava.