Retrophaze
Contributor
Doctors are on a 49020 kick and want it on all colectomy procedures that mention peritonitis, such as 44143 (Hartman's). I specifically asked someone at a seminar this scenario and was told no:
If the doctor opens a patient and finds an abscess on one portion of intestine (say transverse), drains it, and then performs a Hartman's (44143 not involving the transverse), can we bill a 49020-59 with it?
If the doctor opens a patient and finds pus and fecal matter in the abdomen due to perforation, drains it, and then performs a colectomy, can we bill 49020-59 in addition to the colectomy code?
We have an awful lot of colectomies that have perforations or abscess involved. The argument is that a doctor would never leave puss and fecal matter in a patient, thus performing the 49020, as it is not normal to find this in the body. Surgeon's have a whole different perspective than we do...I just don't know where the right and wrong is when it comes to this debate with them.
If the doctor opens a patient and finds an abscess on one portion of intestine (say transverse), drains it, and then performs a Hartman's (44143 not involving the transverse), can we bill a 49020-59 with it?
If the doctor opens a patient and finds pus and fecal matter in the abdomen due to perforation, drains it, and then performs a colectomy, can we bill 49020-59 in addition to the colectomy code?
We have an awful lot of colectomies that have perforations or abscess involved. The argument is that a doctor would never leave puss and fecal matter in a patient, thus performing the 49020, as it is not normal to find this in the body. Surgeon's have a whole different perspective than we do...I just don't know where the right and wrong is when it comes to this debate with them.