AAPC - Back to school
Results 1 to 2 of 2

Thread: Exploratory laparotomy, lysis of adhesions.

  1. #1

    Default Exploratory laparotomy, lysis of adhesions.

    AAPC: Back to School
    How would you code this procedure I'm confused which modifiers to use, would you use 58,78 or 79?
    Small bowel obstruction.

    Small bowel obstruction and uterine fibroids.

    Exploratory laparotomy, lysis of adhesions.

    General anesthesia.




    Patient is a 38-year-old female who has a history of bowel obstructions from adhesions. She re-presented with high grade partial obstruction last week. She was hospitalized and got better with conservative therapy. She was discharged, but immediately returned with progressive pain. X-rays revealed hung up barium in the small bowel from last week. She was taken to the Operating Room where at laparotomy we identified adhesions from her prior operations. There was a focal obstruction of the small bowel, this was at the distal small bowel. Everything proximal was markedly dilated and edematous, distally was decompressed. All the adhesions were lysed. The patient tolerated the procedure well.

    The patient was taken to the Operating Suite, placed in the supine position, given general endotracheal anesthesia, a Foley catheter was inserted and the abdomen was prepped and draped in the usual sterile fashion. She had a lower right paramedian scar and this was excised with the scalpel. We then worked our way down through the old scar and carefully gained entry into the abdomen in the epigastrium. We opened the entire length of the scar carefully and freed adhesions as we went. There were numerous band adhesions. There was an obstruction of the distal small bowel from an internal hernia from adhesions. These bands were lysed, all of the bowel was mobilized from the ligament of Treitz to the ileocecal junction. The prior anastomosis was noted, was patent and the obstruction was just distal to this. We assured that the bowel was healthy. We irrigated the abdomen, aspirated all the fluid and assured hemostasis. The patient had marked fibroids of the uterus. We placed the bowel in a comfortable position and closed
    the abdominal wall en masse with running #2 Nylon suture. The subcutaneous tissues were irrigated, the skin was closed with staples. Sterile dressings were applied. All sponge, needle and instrument counts were correct. The patient tolerated the procedure well and was transferred to the Recovery Room in stable condition.

  2. #2
    Join Date
    Apr 2007
    Northeast Kansas AAPC


    I would use 44005 with diagnosis 560.81

Similar Threads

  1. Replies: 2
    Last Post: 10-18-2013, 03:52 AM
  2. Exploratory laparotomy,Lysis of adhesions,Mesenteric repair
    By bill2doc in forum Gastroenterology
    Replies: 0
    Last Post: 06-24-2013, 03:40 PM
  3. Replies: 0
    Last Post: 06-21-2013, 08:30 AM
  4. Exploratory laparotomy, lysis of adhesions
    By jwschroeterjr@gmail.com in forum Anesthesia
    Replies: 2
    Last Post: 04-05-2011, 07:15 AM
  5. Exploratory Laparotomy,Lysis of Adhesions
    By Trendale in forum General Surgery
    Replies: 6
    Last Post: 04-07-2008, 02:57 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.