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Infarcted omentum resection--please advise!

  1. #1
    Default Infarcted omentum resection--please advise!
    Medical Coding Books
    Hello all,

    I have a surgeon who did a lap chole, and noted "infarcted omentum seen and adhesions inferiorly". He states, "The infarcted omentum was resected with electrocautery, placed in an Endopouch, and removed. Adhesions to the undersurface of the gallbladder were taken down....".

    The lap chole is no problem, but I'm flummoxed on the omentum issue, between 49326 (omentopexy) or 49329 (unlisted lap procedure of...omentum). It was infarcted and resected, so that seems more than the usual (bundled) adhesiolysis issue. But in reading the description of the omentopexy (Coders' Desk Reference), that doesn't quite fit either. Using the unlisted procedure seems my only choice here, but I was hoping for some additional input here.

    Any advice or suggestions would be appreciated!

  2. Default Infarced omentum resection - - please advise!
    You would bill your lap chole w/a 22 modifier and include the op notes and a letter documenting the reason for the unusual circumstances that warrant extra payment... now whether they pay anything more is another story!

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