Ob-Gyn Coding Alert

Question: How would you code for evacuation of hematoma in a re-opening of a recent laparotomy for postoperative hemoperitoneum? CPT 2000 mentions only 49020 (drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess open) and 49080 (peritoneocentesis, abdominal paracentesis, or peritoneal lavage [diagnostic or therapeutic]; initial).

Andrew Mendoza
University Physicians Inc., Baltimore

Answer: You have two options. The first is to use CPT 49999 (unlisted procedure, abdomen, peritoneum and omentum). Your second option is to use those listed in your question. The 49080 code would be best if the lavage procedure accompanied the evacuation. In either case, the operative notes and an explanation will be necessary to fully explain the procedure.

Source for reader questions: Thomas Alan Kent, CMM, and principal of Kent Medical Management in Dunkirk, Md., an independent coding and practice management consultation company.