Wiki 44955

[FTessaBartels]

I seem to recall reading on this forum that CPT 44955 (appendectomy for indicated purpose performed at same time as other surgery) can be used with the primary procedure is either OPEN or LAPARASCOPIC.

Does anyone have a reference for this? I seem to recall it was posted previously, but I haven't found it and I need a quick response.

We had a baby who presented with intussusception (which was reduced via laparoscopy, so we're forced to use the unlisted lap code 44238 ... another story). When they looked inside, they also discovered an inflammed appendix, so an appy was done as well. I think we should also code 44955. But our billing office feels this can only be used with open procedures.

Thanks in advance

F Tessa Bartels, CPC, CEMC

 

[FTessaBartels]

bump

Anybody? I have a billing manager who will NOT take my word for it and wants to see it in writing from a reliable source.

Thanks in advance for your help.

F Tessa Bartels, CPC, CEMC

 

[RebeccaWoodward*]

Tessa,

I have some literature that states to use 44970 when another lap procedure is being performed.

Unlike open appendectomies performed in conjunction with another open abdominal procedure (which you would bill, when appropriate, using 44955), there is no separate code for laparoscopic appendectomies performed during the same session as another laparoscopic procedure, which means you have to use the only available laparoscopic appendectomy code, even though you would use this same code to report a laparoscopic appendectomy performed on its own.

I can fax or email...just let me know.

I know this is a ped case but below is CMS' policy:

5. CPT code 44970 describes a laparoscopic appendectomy and may be reported separately with another laparoscopic procedure code when a diseased appendix is removed. Since removal of a normal appendix with another laparoscopic procedure is not separately reportable, this code should not be reported for an incidental laparoscopic appendectomy.