The appendix is a 3 1/2-inch-long narrow tube of tissue that projects from the large intestine on right side of the abdomen. Appendicitis is an inflamed appendix, which is removed via an appendectomy, a common emergency operation that medical coding outsourcing companies help surgeons code and report for maximum reimbursement.
The earlier theory was that the appendix served no particular purpose. According to a report published in the Science Daily in 2017, recent research suggests that the appendix could have the important function of serving as a reservoir for beneficial gut bacteria.
Appendicitis occurs when the appendix becomes blockedby stool, a foreign body like food, or cancer. An infection in the body can make the appendix to get blocked and swell. The pain due to appendicitis typically begins around the navel and then moves to the lower right abdomen. The pain increases as the inflammation worsens and eventually becomes severe, requiring emergency surgery. The typical symptoms of appendicitis include:
Other symptoms include dull or sharp pain anywhere in the upper or lower abdomen, back, or rectum, severe cramps, and constipation or diarrhea with gas
Appendicitis must be treated promptly as an inflamed appendix can perforate or burst, causing infectious materials to spill into the abdominal cavity. This can result in serious inflammation of the abdominal cavity’s lining, a condition known as peritonitis, which can become fatal if it is not treated quickly. This is the reason why all cases of appendicitis are treated as medical emergencies.
Appendectomy is considered a Once in a Lifetime procedure since each person has only one appendix and can have only one appendectomy during his or her lifetime. When a single physician or multiple physicians or other health care professionals report a single code from the Appendectomy Code Family, it will be reimbursed only once during a patient’s lifetime.
CPT procedure codes should be reported along with the appropriate ICD-10 codes. The ICD-10 codes for appendicitis are as follows:
Experienced coders in medical billing and coding companies are knowledgeable about the nuances of reporting this common surgical procedure. They will check the operative report to understand the reason for the appendix removal as well as pathology report and can help surgeons bill appendectomies to maximize reimbursement. Search for:
21. Daniell JF, Gurley LD, Kurtz BR, Chamber JF. The use of an automatic stapling device for laparoscopic appendectomy. Obstet Gynecol 1991;78(4):721-723.
16. Harris RS, Foster WG, Surrey MW, Agarwal SK. Appendiceal disease in women with endometriosis and right lower quadrant pain. J Am Assoc Gynecol Laparosc. 2001;8(4):536-541.
20. Jaffe BM, Berger DH. The appendix. In: Brunicardi F Andersen D, Billiar T, et al, eds. Schwartz’s Principles of Surgery. 9th ed. Chapter 30. New York, NY: McGraw Hill Professional; 2010.
Coding for appendectomy is fairly straightforward if you know the rules, but prophylactic removal of the appendix, whether performed at the time of a laparoscopic or open abdominal primary procedure, will usually lead to reimbursement difficulties for surgeons even though CPT codes exist to report the procedure. Knowing when and how to bill and document the circumstances for removal will go a long way in getting payment for the procedure. Note that these rules apply to a single surgeon who is performing the entire surgery. When an ObGyn is performing gyn procedures, but a general surgeon is the one who removes the appendix, that surgeon will not be subject to bundling rules, but will still have to make a case with the payer for removing an otherwise normal appendix.
Keep in mind that code 44970 is bundled into a long list of laparoscopic procedures, including codes for treating stress urinary incontinence and prolapse (CPT codes 51990–51992, 57425), sterilization procedures (CPT codes 58670–58671), hysterectomy procedures (CPT codes 58541–58544, 58548, 58550–58554, 58570–58573), myomectomy procedures (CPT code 58545–58546), as well as codes for lysis, removal of lesions and ovaries, or aspiration of lesions (CPT codes 49321–49322, 58660–58662). A modifier -59 (Distinct Procedural Service) can be reported to bypass these edits, but the payer will request documentation to ensure that the criteria for using this modifier apply. The CPT criteria include documentation of a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) which is not ordinarily encountered or performed on the same day by the same individual. Failure to discuss the reason for the removal in the body of the operative report will generally mean the payer will deny extra payment for the appendectomy.
The earlier theory was that the appendix served no particular purpose. According to a report published in the Science Daily in 2017, recent research suggests that the appendix could have the important function of serving as a reservoir for beneficial gut bacteria.
The appendix is a 3 1/2-inch-long narrow tube of tissue that projects from the large intestine on right side of the abdomen. Appendicitis is an inflamed appendix, which is removed via an appendectomy, a common emergency operation that medical coding outsourcing companies help surgeons code and report for maximum reimbursement.
Appendectomy is considered a Once in a Lifetime procedure since each person has only one appendix and can have only one appendectomy during his or her lifetime. When a single physician or multiple physicians or other health care professionals report a single code from the Appendectomy Code Family, it will be reimbursed only once during a patient’s lifetime.
Appendicitis occurs when the appendix becomes blockedby stool, a foreign body like food, or cancer. An infection in the body can make the appendix to get blocked and swell. The pain due to appendicitis typically begins around the navel and then moves to the lower right abdomen. The pain increases as the inflammation worsens and eventually becomes severe, requiring emergency surgery. The typical symptoms of appendicitis include:
Experienced coders in medical billing and coding companies are knowledgeable about the nuances of reporting this common surgical procedure. They will check the operative report to understand the reason for the appendix removal as well as pathology report and can help surgeons bill appendectomies to maximize reimbursement. Search for:
Description Of Laparoscopic Appendectomy CPT Codes
Four different CPT codes may be employed as far as appendectomy is concerned. These codes have a significant difference, but they are related to appendectomy.
The laparoscopic appendectomy CPT codes include;
CPT 44950 is described as the appendectomy performed through an open incision in the abdomen).
CPT 44960 is described as the appendectomy performed through an open incision in the abdomen for ruptured appendix which may have an abscess or general peritonitis.
CPT 44970 describes as laparoscopy for appendectomy. For more information about CPT code 44970, follow this >> link <<
CPT 44979 is described as Unlisted laparoscopic operating procedures relating to an appendix.
FAQ
What is the CPT code 44970?
Is CPT 44955 open or laparoscopic?
What is the CPT code for surgical laparoscopy?
What code should be used to report a laparoscopic appendectomy at time of another major procedure?
