Resolved Drainage of pelvic abscess

[ErnaV_2250]

Good day

Please can I ask for some advice. The patient went for a laparoscopic drainage of a pelvic abscess as well as aan appendectomy.
Diagnostic information: Appendicitis that caused an abscess in the abdominal cavity.

Will this be coded as 49322 Laparoscopy, surgical; with aspiration of cavity or cyst as well as the 44970 Laparoscopy surgical, appendectomy?
Or do one use the 49329 unlisted code in addition to the 44970? or only the 44970?
Or perhaps use 44979 and 49329?


Thanks Erna

 

[Alicia]

Is the abcess part of the appendix or did they just decide to take it out because they were in there? Because sometimes cleaning up is bundled.

Here is a CPT Assistant Archive

December 2019 pages 12-13​

Question: What code should be reported for a laparoscopic appendectomy for ruptured appendix? Code 44970 (laparoscopic appendectomy) does not fully account for the work involved in this procedure and code 44960 is only reported for an open appendectomy for ruptured appendix.

Answer: Code 44970, Laparoscopy, surgical, appendectomy, should be reported. Depending on the amount of extra time and/or work effort required when compared to a laparoscopic appendectomy without rupture, it may be appropriate to append modifier 22, Increased procedural services. Documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient’s condition, physical and mental effort required).

 

[ErnaV_2250]

Is the abcess part of the appendix or did they just decide to take it out because they were in there? Because sometimes cleaning up is bundled.

Here is a CPT Assistant Archive

December 2019 pages 12-13​

Question: What code should be reported for a laparoscopic appendectomy for ruptured appendix? Code 44970 (laparoscopic appendectomy) does not fully account for the work involved in this procedure and code 44960 is only reported for an open appendectomy for ruptured appendix.

Answer: Code 44970, Laparoscopy, surgical, appendectomy, should be reported. Depending on the amount of extra time and/or work effort required when compared to a laparoscopic appendectomy without rupture, it may be appropriate to append modifier 22, Increased procedural services. Documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient’s condition, physical and mental effort required).

Thank you this answers me. its cleaning up and I think bundled

 

[ErnaV_2250]

Thanks Alicia, I think you answered my question. 2 different things , appendix not ruptured

 

[Alicia]

But do remember they get to show extra work was done.

 

[ErnaV_2250]

But do remember they get to show extra work was done.

Thanks.