tci General Surgery Coding Alert - 2009 Issue 3

Reader Questions: Support Appendectomy With Medical Necessity

Question: During bariatric surgery (43846) on a patient, the surgeon removed the patient's appendix. Can I report the appendectomy separately? New Jersey Subscriber Answer: Whether you can report the appendectomy separately depends on whether the surgeon's documentation shows medical necessity for removing the appendix. The surgeon needs to document that the appendix appeared abnormal and needed to be removed -- for example, because of scarring or inflammation. Surgeons often remove the appendix during bariatric surgery (as in this example, 43846, Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb [150 cm or less] Roux-en-Y gastroenterostomy). If...

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