natashalage
Expert
Hello. Could you please tell me if i can add 44110 to the excision of Ovary 58661 in the report below or I should just add a modifier -22? Thank you very much in advance. I am a new coder.
FINDINGS:
1. .. the uterus and cervix to be surgically absent.
2. On laparoscopy, .. to have adhesions of the sigmoid colon to the left ovary and the anterior abdominal wall. After taking down adhesions, the left ovary was still adherent to the left sidewall including the residual left round ligament. On removal of the ovary, the cyst ruptured for chocolate fluid and, after resecting the ovary, there were two areas of bowel that were stapled over an oversewn. ..The appendix was surgically absent.
PROCEDURE: Left oophorectomy 58661… for a combined abdominoperineal procedure. .. We made three laparoscopic incisions … The peritoneal cavity was insufflated with 3 liters of carbon dioxide gas …. We noted adhesions of the sigmoid colon to the anterior abdominal wall. …n the adhesions close to the bowel by sharp dissection using scissors. We dissected the mass away from the sigmoid colon. We entered the cyst for chocolate fluid and decompressed the ovary. Prior to removal, we opened up the retroperitoneum to identify the sidewall vessels as well as the ureter. We detached adhesions of the left adnexa to the right adnexa. Having taken down the various adhesions, we were able to mobilize the left adnexal mass. We ended up resecting some scar tissue that was adherent to the left round ligament and anterior abdominal wall along with the ovarian tumor. …we examined the pelvis and noted that there was a diverticulum from the sigmoid that was particularly involved with adhesions. Given the degree of adhesiolysis and despite our shar dissection, we elected to resect the small area of protrusion. .. We used an Endo GIA stapler to resect the outpouching from the sigmoid diverticulum, and this was given to Pathology. A secure staple line was noted. There was a second area on the sigmoid colon where there was some deserosalization of the bowel. …
44110-Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy
FINDINGS:
1. .. the uterus and cervix to be surgically absent.
2. On laparoscopy, .. to have adhesions of the sigmoid colon to the left ovary and the anterior abdominal wall. After taking down adhesions, the left ovary was still adherent to the left sidewall including the residual left round ligament. On removal of the ovary, the cyst ruptured for chocolate fluid and, after resecting the ovary, there were two areas of bowel that were stapled over an oversewn. ..The appendix was surgically absent.
PROCEDURE: Left oophorectomy 58661… for a combined abdominoperineal procedure. .. We made three laparoscopic incisions … The peritoneal cavity was insufflated with 3 liters of carbon dioxide gas …. We noted adhesions of the sigmoid colon to the anterior abdominal wall. …n the adhesions close to the bowel by sharp dissection using scissors. We dissected the mass away from the sigmoid colon. We entered the cyst for chocolate fluid and decompressed the ovary. Prior to removal, we opened up the retroperitoneum to identify the sidewall vessels as well as the ureter. We detached adhesions of the left adnexa to the right adnexa. Having taken down the various adhesions, we were able to mobilize the left adnexal mass. We ended up resecting some scar tissue that was adherent to the left round ligament and anterior abdominal wall along with the ovarian tumor. …we examined the pelvis and noted that there was a diverticulum from the sigmoid that was particularly involved with adhesions. Given the degree of adhesiolysis and despite our shar dissection, we elected to resect the small area of protrusion. .. We used an Endo GIA stapler to resect the outpouching from the sigmoid diverticulum, and this was given to Pathology. A secure staple line was noted. There was a second area on the sigmoid colon where there was some deserosalization of the bowel. …
44110-Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy