Debra Posted Wed 12th of February, 2020 16:43:34 PM
NCCI edits state: A diagnostic laparoscopy includes "washing", infusion and/or removal of fluid from the body cavity. A physician shall not report CPT codes 49082-49083 (abdominal paracentesis) or 49084 (peritoneal lavage) for infusion and/or removal of fluid from the body cavity performed during a diagnostic or surgical laparoscopic procedure. Can you please provide further clarification on when documentation would support CPT 49804 (peritoneal lavage) when a laparoscopic appendectomy is being performed? I have a provider that is documenting laparoscopic appendectomy with an abdominal washout and drainage and I need an understanding of the "washing" included in CPT 44970 versus the lavage CPT 49084.
SuperCoder Answered Thu 13th of February, 2020 02:57:40 AM
Thanks for your question.
Lavage means to wash, which typically involves instillation of a saline solution or water and suction to remove it. Lavage or washing is an integral part of the laparoscopic appendectomy and hence it is included in this procedure.
Moreover, there is CCI edit between codes 44970 and 49084 but you may use a CCI-associated modifier to override the edit under appropriate circumstances when performed for a different diagnosis e.g. peritonitis, Syphilis of liver and other viscera, noninfective disorders of lymphatic vessels and lymph nodes, ascites, Injury of peritoneum etc.
Please feel free to write if you have any question.