Diag.Laparoscopy/Laparotomy

Hopp

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Hi everyone! Please help with the following? Doc performs a diagnostic laparoscopy and encounters bowel problems adhesions. He now does decompresses and does a laparotomy, lysis of adhesions and an incidental appendectomy (Path:normal appendix). Would I code the lysis of adhesions?
Thanks in advance for helping with this? In addition he did a biopsy of a messenteric nodule - I don't think I can bill this as stated in the CPT book - separate procedure am I correct?
 
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amitjoshi4

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49000 is the code to be used here. In performing Laparotomy, lysis of adhesions is inclusive.

Thank You
 

Treetoad

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I agree with Melissa. If adhesiolysis is performed, it's no longer an exploratory laparotomy.
 

dmaec

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I also agree with Melissa and Treetoad - If adhesiolysis is performed, it's no longer an exploratory laparotomy.
Donna
 
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Hi everyone! Please help with the following? Doc performs a diagnostic laparoscopy and encounters bowel problems adhesions. He now does decompresses and does a laparotomy, lysis of adhesions and an incidental appendectomy (Path:normal appendix). Would I code the lysis of adhesions?
Thanks in advance for helping with this? In addition he did a biopsy of a messenteric nodule - I don't think I can bill this as stated in the CPT book - separate procedure am I correct?
I would definitely agree, 44005 would be the way to go. If the patient has an obstruction secondary to adhesions (such as a SBO) I would use ICD-9 code 560.81 "adhesions, intestine, with obstruction". An exploratory lap does not include LOA.
 

viborges

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Need code

CODING FOR EXPLORATORY LAPAROSCOPY FOLLOWED BY LAPAROTOMY, LYSIS OF ADHESION'SQJhx54&$Q3qSMJ5 AND REPAIR OF GASTRIC PERFORATION.
Anyone know the code for this, doctor says to use 43840 with dx of 8630 and mod 79(this is a return)
thanks
 

surgonc87

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CODING FOR EXPLORATORY LAPAROSCOPY FOLLOWED BY LAPAROTOMY, LYSIS OF ADHESION'SQJhx54&$Q3qSMJ5 AND REPAIR OF GASTRIC PERFORATION.
Anyone know the code for this, doctor says to use 43840 with dx of 8630 and mod 79(this is a return)
thanks
If the perforation was ensued by the LOA, then its a no go. Just report the LOA in that case. Otherwise if exploration was done, and perforation was there as a result of something else, the code 43840 by all means.
 
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