Appendectomy Question

BABS37

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Hi. My physician did a laparoscopic appendectomy and then continued to rummage through the patient trying to find the cause of her pain. He then biopsies a peritoneal implant and then finds a BBQ grill brush wire that perforated the patients small bowel so continues with removal of foreign body and closure of enterotomy. If I have the right codes picked, can I bill them?

44227
49320
44970-59 as this bumps with 44227

Any advice?
 
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Good Afternoon. I think you can only bill the 44227. You could add a 22 modifier for the additional work but be prepared to send supporting docutmentation. I hope this helps. Does anyone else have an idea about how this should be coded?
:rolleyes:
 

BABS37

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Thank you thank you! I think I'll take your advice and add the 22 modifier and drop the other two codes. :)
 

heathermc

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per ncci edits you may use 44227 along with 44970 with a 59 modifier. i would only charge this way if pathology states that there was something wrong with appendix though. if the appendix was benign or had no pathological diagnosis you could only charge the 44227.
 

BABS37

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Thank you! I went with the 22 modifier before I got your response. But now I'm thinking that there wasn't anything wrong with his appendix- everything came back normal and no inflammation. I sent the OP notes in with it but that made me think of another surgery. If he removes an appendix and there isn't anything wrong- can he still bill for those? Like- lets say he schedules the surgery for appendicitis and then finds nothing wrong with is but removes it anyway... thoughts?
 
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