Wiki Bowel mass? Need help

[Rgreen0118]

Not sure how to code this one: A little of my OBGYN league.......Can anyone help with this?

diagnostic laparoscopy, pelvic adhesions = 49320

Op note reads:
Bullet nose graspers and cautery scissors used to take down the left sided pelvic adhesions and "remove the large - bowel cystic mass?"

How do you code the excision of the bowel mass? Should I just add a 22 modifier?

Thanks in advance!
__________________
Rhonda Green, CPC

 

[Faizia Khan]

How about 44110-22 (excision of 1 or more lesion of small/large intestine not requiring anastomosis, exteriorization/fistulization; single enterotomy) ?

 

[cmartin]

Sounds like it may be an unlisted laparoscopic procedure, intestine (44238). (Lap lysis of intestinal adhesions is 44180, but it sounds like the main thing here was the excision of a cystic mass from the large bowel?)

 

[colorectal surgeon]

how about

49203. Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less

49204. Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter

49205. Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter

 

[surgonc87]

49321 Laparoscopy, surigical; with biopsy (single or multiple)

They dont know what that mass is yet, so this code best reports it laparoscopy.

MS