tci General Surgery Coding Alert - 2020 Issue Q3

Reader Questions: Find 'Debulking' Code for Recurrent Tumor

Question: The surgeon excised a 6.6 x 4.6 x 3.4 cm pelvic mass attached to the lesser pelvic sidewall and the rectosigmoid. The clear margins included rectosigmoid serosa, and the surgeon repaired the rectosigmoid defect. The surgeon also removed three “nodules” from the liver, rectum, and sigmoid that were 3.3, 1.9, and 2.3 cm in size, respectively. The patient had recurrent ovarian cancer. Should I code the procedure as 49204? California Subscriber Answer: No, code 49204 (Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal...

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