Wiki Appendectomy confusion!!

[AR2728]

I have recently taken on surgical coding and I am very confused by what I have been taught and what I have read in the coding companion regarding appendectomy codes 44950 & 44955.

It appears that 44950 should only be used in the istance of an incidental appendectomy. So when my surgeon performs an expl laparotomy that reveals acute appendicitis, then performs the appendectomy I would code 49000 and 44955. The previous coders nearly always billed 44950 for every appendectomy. Can someone please explain when 44950 is appropriate to bill? Will I nearly always code 44955 when done with another procedure and there is an indicated diagnosis? I'm extremly frustrated and confused by what I have been taught and what I have read.

 

[mitchellde]

Let me see if I can help.
1- 44950 is not for incidental appy. It is for the appy the note on incident says IF this is an incidental appy then either do not report it or use the code with a 52 modifier.
2 - 44955 is an add on code when at the time of another major procedure you alos performed an appy not as incidental.
3 - you do not report the exploratory procedure once a definitive procedure is performed. In otherwords the exploratory was the approach for the appy.
4 - If the exploratory was performed for a problem such as abd pain and the appendix was revealed as the source of the pain then code an appy 44950. If they mad the decision to take the appendix just because they were already there so why not, then it is incidental so you should not code it.
So in your descibed incident with the acute appendicitis then code 44950

 

[mjewett]

Code 49000 is bundled with code 44950, so code 49000 can not be billed. Code 44955 is not a stand alone code, since you can't bill 49000 then you can't bill 44955.

This is an example of when to use the add on code 44955:

The surgeon is removing the gallbladder (47600), and happens to notice the appendix looks abnormal, therefore the surgeon decides to go ahead and removed the appendix during that surgery. In this case you would bill whatever the appropriate gallbladder code would be, for example, 47600, and code 44955.

If your surgeon does an exploratory laparotomy and removes the appendix you would only bill 44950. (Code 49000 is included in code 44950.)

Also the add on code 44955 can be used in open or laparoscopic surgeries.

I hope this helps.

 

[AR2728]

Thank you fellow coders. I can take a sigh of relief, this now makes perfect sense.

 

[machi57]

Appendectomy

Hello fellow coders...

During c-section, dr sees a problem with/appendix, decides to remove, 44955, correct?

Thanks a bunch, Rose:

 

[gotro123]

Code 49000 is bundled with code 44950, so code 49000 can not be billed. Code 44955 is not a stand alone code, since you can't bill 49000 then you can't bill 44955.

This is an example of when to use the add on code 44955:

The surgeon is removing the gallbladder (47600), and happens to notice the appendix looks abnormal, therefore the surgeon decides to go ahead and removed the appendix during that surgery. In this case you would bill whatever the appropriate gallbladder code would be, for example, 47600, and code 44955.

If your surgeon does an exploratory laparotomy and removes the appendix you would only bill 44950. (Code 49000 is included in code 44950.)

Also the add on code 44955 can be used in open or laparoscopic surgeries.

I hope this helps.

44955 is not used for both open or laparoscopic surgeries according to CPT assistant January 2012- "There is no CPT code to report a laparoscopic appendectomy when done for an indicated purpose at the time of another major procedure. Therefore, unlisted code 44979, Unlisted laparoscopy procedure, appendix, would be reported. ..." This information came out after the post but I wanted to post this current information for people researching this topic.

 

[suec]

If a laparoscopic appendectomy and laparoscopic cholecystectomy are scheduled & done together, do we use the unlisted code 44979? What during if during a laparoscopic cholecystectomy they find a diseases appendix, not previously known, and removed it laparoscopically, use 44979 or 44950? The 2023 NCCI Manual Chapter 6 has me confused. Seems to contradict the 2012 CPT assistant under te unlisted code. Thank you for any info.