Reporting Appendix Procedures

Incision and drainage of an appendiceal abscess through an open incision is coded 44900. CPT’s parenthetical note tells us to use 49406 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous for a percutaneous image-guided drainage by catheter of an appendiceal abscess.

Reported as an Open Approach

An appendectomy performed through an open approach is coded 44950 Appendectomy. Read the operative note carefully because if the appendix is ruptured with an abscess or generalized peritonitis, you will want to choose 44960 Appendectomy; for ruptured appendix with abscess or generalized peritonitis.

Reported as an Add-on Code

If an appendectomy is performed using an open approach for an indicated purpose at the time of a major procedure, report add-on code +44955 Appendectomy; when done for indicated purpose at the time of other major procedure (not as separate procedure).

Reported as a Lap Approach

When it comes to a laparoscopic approach, there are only two codes to choose from. The first is 44970 Laparoscopic, surgical, appendectomy. The second is the most dreaded code for a physician who gets paid based on RVUs, 44979 Unlisted laparoscopy procedure, appendix.

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Angela Clements

Physician Coding Auditor, Educator & Consultant at Medkoder

Angela is a Physician Coding Auditor, Educator& Consultant at Medkoder. She has over 18 years of experience in the healthcare industry. Clements serves on the AAPC NAB as the Member Relations Officer and served as Region 5 Representative from 2013-2015. She is a frequent speaker at local medical managers' meetings and local chapters in her region.

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