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Excision/Removal Staples left during previous surgery

  1. Default Excision/Removal Staples left during previous surgery
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    My OBGYN did a laparoscopy where he discovered several lines of staples in the abdominal wall from a previous surgery that were causing severe pelvic pain. The only code I can find that is relating to removal of foreign body from a prior surgery is 49402 but it appears to be an open procedure. What should I code for the laparoscopic procedure, can I use lysis of adhesions?
    Here is an excerpt from the op report after the lasparoscopy was started and all scopes in place:
    "The following findings were noted. The patient had several small implants of endometriosis in the posterior cul-de-sac. She had a previous hysterectomy with removal of the right tube and ovary and the left ovary appeared normal. The patient had multiple staple lines incorporating the right pelvic sidewall as well as the vaginal cuff as well as the left pelvic sidewall. Any implants of endometriosis were sharply dissected. Following this, attention was paid to the multiple suture lines of the staples. The peritoneum was grasped and using the Harmonic, the peritoneum incorporating the staples was sharply dissected. Specimens were removed. ......."
    Can someone point me in the right direction?


  2. #2
    Default Laproscopic removal of staples left during previos surgery
    Hi, did you ever find a resolution to this procedure finding? I have a similar situation where the provider was doing a diagnostic laparoscopy to determine how bad a patient's endometriosis had developed and whether or not to remove the spreading growth. While the provider was exploring, she found a metallic stitch in the pelvic sidewall that was left from an appendix surgery years prior.

    I want to code 58662 because endometriosis was removed during the laparoscopy and maybe 49329 for unlisted laparoscopy procedure, abdomen, peritoneum, and omentum for the removal of the metallic stitch.

    Do you have any suggestions or advice on how you handled your situation?
    Thank you in advance!

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