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Diag.Laparoscopy/Laparotomy

  1. #1
    Default Diag.Laparoscopy/Laparotomy
    Medical Coding Books
    Hi everyone! Please help with the following? Doc performs a diagnostic laparoscopy and encounters bowel problems adhesions. He now does decompresses and does a laparotomy, lysis of adhesions and an incidental appendectomy (Path:normal appendix). Would I code the lysis of adhesions?
    Thanks in advance for helping with this? In addition he did a biopsy of a messenteric nodule - I don't think I can bill this as stated in the CPT book - separate procedure am I correct?
    Last edited by Hopp; 07-09-2008 at 02:54 PM. Reason: Additional procedure performed at the same time

  2. Arrow
    49000 is the code to be used here. In performing Laparotomy, lysis of adhesions is inclusive.

    Thank You
    Amit Joshi MSc,CPC,CPC-H

  3. #3
    Location
    St. Louis, Missouri
    Posts
    262
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    I would use 44005 and use V64.41 as one of your secondary diagnosis codes.

    Melissa Blow, CPC

  4. Default
    I agree with Melissa. If adhesiolysis is performed, it's no longer an exploratory laparotomy.

    ~L
    CPC, CGSC, COSC

  5. #5
    Location
    Duluth, Minnesota
    Posts
    1,133
    Default
    I also agree with Melissa and Treetoad - If adhesiolysis is performed, it's no longer an exploratory laparotomy.
    Donna

  6. #6
    Default
    Quote Originally Posted by Hopp View Post
    Hi everyone! Please help with the following? Doc performs a diagnostic laparoscopy and encounters bowel problems adhesions. He now does decompresses and does a laparotomy, lysis of adhesions and an incidental appendectomy (Path:normal appendix). Would I code the lysis of adhesions?
    Thanks in advance for helping with this? In addition he did a biopsy of a messenteric nodule - I don't think I can bill this as stated in the CPT book - separate procedure am I correct?
    I would definitely agree, 44005 would be the way to go. If the patient has an obstruction secondary to adhesions (such as a SBO) I would use ICD-9 code 560.81 "adhesions, intestine, with obstruction". An exploratory lap does not include LOA.

  7. Default Need code
    CODING FOR EXPLORATORY LAPAROSCOPY FOLLOWED BY LAPAROTOMY, LYSIS OF ADHESION'SQJhx54&$Q3qSMJ5 AND REPAIR OF GASTRIC PERFORATION.
    Anyone know the code for this, doctor says to use 43840 with dx of 8630 and mod 79(this is a return)
    thanks

  8. #8
    Default
    Quote Originally Posted by viborges View Post
    CODING FOR EXPLORATORY LAPAROSCOPY FOLLOWED BY LAPAROTOMY, LYSIS OF ADHESION'SQJhx54&$Q3qSMJ5 AND REPAIR OF GASTRIC PERFORATION.
    Anyone know the code for this, doctor says to use 43840 with dx of 8630 and mod 79(this is a return)
    thanks
    If the perforation was ensued by the LOA, then its a no go. Just report the LOA in that case. Otherwise if exploration was done, and perforation was there as a result of something else, the code 43840 by all means.

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