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Thread: help with appendectomy

  1. #1

    Red face help with appendectomy

    AAPC: Back to School

    I need help with an perforated appendectomy. It was done open. Upon opening there was a definite abscess which was entered and drained with suction. ( Is that chargeable? ) Then he went ahead and transected the ruptured appendix. I'm looking a 44960 and 44900. Not sure if 44900 is really chargeable.

    Then a few days later he took her back in and did a exploratory lap with drainage of intraabdominal abscesses. Lots of fluid in the pelvis and other areas were aspirated along with some debridement of jelly-like and fibrinous material from the subhepatic area. I'm looking at 49020 or 49081. Please give me some opinions of what you think.

  2. #2
    Join Date
    Apr 2007
    Johnson City


    Code 44960 and code 44900 are bundled according to the National Correct Coding Edits. So I believe code 44960 is all you should bill for the first day.

    For the surgery performed a few days later I would bill 49002-78.

    CPT states code 49020 "Drainage of peritoneal abscess or localized peritonitis EXCLUSIVE of appendiceal abscess; open". So code 49020 is not to be used when related to a appendiceal abscess.

    Code 49081 is not an open code the lay description in General Surgery Coding Companion 2008, indicates this procedure involves withdrawing fluid with a needle.

    I hope this helps,

  3. #3


    Thank you for your help. I read 44020 the opposite of what it says. I understand why you chose those codes and I will go ahead and give it a try. Thank you again.

    Do you find the General Surgery Coding Companion really helpful?

  4. #4
    Join Date
    Apr 2007
    Johnson City


    I know what you mean. I think the first time I read the description to code 44020, I was confused too.

    I use the General Surgery Coding Companion every day. It is an excellent tool. When I first started working in this General Surgery practice. I used it alot b/c it has an explanation of each code and it reads like the op report would. It also lists RVU's, follow up days, and if assistant surgeons are approved for the code.


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