Wiki help with appendectomy

[bwerner]

Hello,

I need help with an perforated appendectomy. It was done open. Upon opening there was a definite abscess which was entered and drained with suction. ( Is that chargeable? ) Then he went ahead and transected the ruptured appendix. I'm looking a 44960 and 44900. Not sure if 44900 is really chargeable.

Then a few days later he took her back in and did a exploratory lap with drainage of intraabdominal abscesses. Lots of fluid in the pelvis and other areas were aspirated along with some debridement of jelly-like and fibrinous material from the subhepatic area. I'm looking at 49020 or 49081. Please give me some opinions of what you think.

 

[mjewett]

Code 44960 and code 44900 are bundled according to the National Correct Coding Edits. So I believe code 44960 is all you should bill for the first day.

For the surgery performed a few days later I would bill 49002-78.

CPT states code 49020 "Drainage of peritoneal abscess or localized peritonitis EXCLUSIVE of appendiceal abscess; open". So code 49020 is not to be used when related to a appendiceal abscess.

Code 49081 is not an open code the lay description in General Surgery Coding Companion 2008, indicates this procedure involves withdrawing fluid with a needle.

I hope this helps,
Melissa-CPC

 

[bwerner]

Thank you for your help. I read 44020 the opposite of what it says. I understand why you chose those codes and I will go ahead and give it a try. Thank you again.

Do you find the General Surgery Coding Companion really helpful?

 

[mjewett]

I know what you mean. I think the first time I read the description to code 44020, I was confused too.

I use the General Surgery Coding Companion every day. It is an excellent tool. When I first started working in this General Surgery practice. I used it alot b/c it has an explanation of each code and it reads like the op report would. It also lists RVU's, follow up days, and if assistant surgeons are approved for the code.

Melissa-CPC