tci Outpatient Facility Coding Alert - 2019 Issue 3

Reader Question: Know What Qualifies as Incidental, Separately Billable Intraoperative Appendectomy

Question: While performing an open gallbladder removal, the surgeon noted localized peritonitis associated with acute appendicitis. The surgeon then removed the appendix. Is the appendectomy bundled with the gallbladder removal for coding purposes? Tennessee Subscriber Answer: You can separately code the cholecystectomy and the appendectomy in this case. Although you must bundle “incidental” appendectomy with other abdominal procedures, you can separately bill the appendix removal in many cases when the surgeon notes distinct pathology. Report this case as 47600 (Cholecystectomy) and +44955 (Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure)...

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