Wiki Appendectomy w/ partial cecectomy and ileocecectomy

[silvertiger]

I have been going in circles with this, can any one help:
The Dr dropped: 44110/49000/49320/49020 - I coded: 44960/44110, for a second I thought maybe 44160-52 only, I am just not sure.
Anyone up for the challenge??

Procedure Performed
1. Diagnostic laparoscopy converted to open exploratory laparotomy
2. Appendectomy
3. Ileocecectomy
4. Abdominal washout and drain placement

 

[daniel]

I see CPT 44160.52 no anastomosis.......... +44955 but that seems to bundle with no modifier 59 allowed.

 

[lindam@caricures.com]

I am having a similar issue - Appendectomy w/partial cecectomy - Laparoscopy - "we identified the cecum. There was some atypical attachments of the ileum to the appendix. Using the vessel sealing device we took down the fatty attachments. We were now able to retract the appendix up off the cecum. The base of the appendix definitely had an atypical appearance. It was as if it was imbricated into the cecum. I could feel and see what appeared to be the polyp inside the appendix entering into the cecum. We took the mesentery of the appendix with the vessel sealing device. We could not visualize the base of the appendix easily and what appeared to be a polypoid mass inside. Using an Endo GIA w/a 60 load I was able to place the stapler below this atypical area and close it down. With 2 firings of the stapler we removed a portion of the cecum and appendix and what appeared to be this appendiceal polyp." It seems like more than just an appendectomy, but no anastomosis so I am guessing only 44970 is appropriate. Any thoughts?

 

[daniel]

For this specific context, Appendectomy w/partial cecectomy. Use 44970/44950 only.