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Wiki Open Appendectomy w/drainage w/OUT rupture

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AT2728

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I have a situation where physician performed an open appendectomy along with drainage of periappendicial and pelvic seropurulent fluid. The physician stated no gross perforation found but could not rule out micro-perf due to fluid. Path found NO perforation. I now have an open appendectomy with drainage of fluid but no rupture. I believe this leaves me coding 44950 since 44960 specifically states ruptured, meaning my physician will receive no extra payment for the drainage. Would someone please verify?
 
If you cannot document the perforation I would not code for it. However, if the physician documented extenuating circumtances and additional time spent, you may be able to use modifier 22 for additional reimbursement
 
Thank you. I just reviewed this again today and say your response. He certainly performed extra work, but the path and his dictation clearly state no perf. located.
 
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