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Diagnostic Lap conversion to Laparotomy

  1. Default Diagnostic Lap conversion to Laparotomy
    Medical Coding Books
    Can someone assist me in coding the following procedures:

    1. Diagnostic Laparoscopy conversion to Laparotomy
    2. Massive lysis of adhesions
    3. Removal of FB consisting of Mesh

    DX: 625.8 599.70 V64.41
    Should I code a FB code for the removal of mesh, or should I go into the complication section? The patient previously had a abdominal wall reconstruction and hernia repair. The hernia was very large and draped over the bladder, which was causing the pelvic pain and hematuria. The mesh had had become strongly adherent on to the abdominal wall and to the bowel, large and small intestine as well, so the physcian needed to remove the mesh. The physcian converted from a diagnostic Lap to an open becauuse the mesh was too large and there was a lot of adhesions. As I understand, I can not code for the removal of adhesions as this is inclusive to the procedure, unless the physcian spent a lot of time removing it and if it is stated in the report, in which this case he did not mention a specified time.
    In my coding companion 599.70 is not listed as a covered dx for this procedure, 625.8 is, what code should I use for the 11008 removal of mesh?

    Thanks for your help!

    The codes I have is 49000 and 11008

  2. Default
    I have always been told to use 49999 for removal of mesh and send the op notes with the claim. This should be the only code used.

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