Wiki Laparoscopic lysis of adhesions/excision of left lower quad colostomy site scar tissue 20 sq cm of skin, subcuntanous fat removed

[rconpatton]

A 5-mm incision in the left upper quadrant Palmer's point, carried down the fascia. Grasping the fascia, elevating it, placing a Veress needle, insufflating the abdomen, placed a 5-mm Optiview scope without difficulty, placing 3 additional ports, all 5 mm in size, one right upper quadrant, one right flank, one right lower quadrant. We examined the old ostomy sit. We took down multiple adhesion's of the small bowel and the omentum to the anterior abdominal wall. There was no hernia present. The fascia was completely intact. There was no other intra-abdominal abnormality noted and ports and gas were withdrawn. I then made incision approximately 2 inches in size in the left upper quadrant. Overall ostomy site excised scar and used electrocautery to excise multiple areas of scarring the subcutaneous fat all the way down to the fascia, which was left intact and again noted to be intact. We then copiously irrigated the would. Closed the skin with staples and Band-Aids. Pt tolerated the procedure well..

I wanted to code 49329, but the excision of subcutaneous scar tissue stops me. Should I code for the lysis of adhesion's or just excision codes for complex removal? Any help will be appreciated.

 

[haraml7]

I personally would bill for the lysis of adhesions, because billing for an unlisted code would not really be appropriate as there is a stated procedure performed in the posted criteria above.

Thanks