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Diagnostic Lap conversion to Laparotomy - hould I code a FB code

  1. Default Diagnostic Lap conversion to Laparotomy - hould I code a FB code
    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

    The codes I have is 49000 and 11008

    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!

  2. #2
    Quincy, MA
    I don't think you can bill 11008 with 49000, CPT says:

    Use 11008 in conjunction with 10180, 11004-11006

    I'm thinking maybe just 44005 for the open enterolysis???
    Leanne, CPC
    General/Vascular Surgery

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