How To Use CPT Code 44950

CPT 44950 describes the surgical removal of the appendix due to inflammation. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44950?

CPT 44950 is used to describe the surgical removal of the appendix, specifically for cases of inflammation. This procedure is performed to relieve pain and prevent infection or rupture. It is important to note that incidental appendectomy during intra-abdominal surgery does not usually warrant a separate identification, but if necessary to report, modifier 52 should be added.

2. Official Description

The official description of CPT code 44950 is the surgical removal of the appendix due to inflammation. It is important to understand that this code should only be used when the appendix is inflamed and requires removal. Incidental appendectomy, which involves the removal of a noninflamed or healthy appendix as a precautionary measure during a major primary procedure on the abdomen or pelvis, should not be reported separately.

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. An incision is made over the right lower quadrant of the abdomen.
3. The provider enters the abdomen and identifies the inflamed appendix.
4. Any pus is suctioned out, and the area is washed with saline solution.
5. The provider then removes the inflamed appendix.
6. The cut edges of the intestines are closed, and the provider checks for bleeding.
7. Any instruments are removed, and the abdominal incision is closed in layers.

4. Qualifying circumstances

CPT 44950 is used when the appendix is inflamed and requires surgical removal. It is important to note that incidental appendectomy, which involves the removal of a noninflamed or healthy appendix as a precautionary measure during a major primary procedure on the abdomen or pelvis, should not be reported separately. The decision to perform an appendectomy is based on the clinical judgment of the provider, taking into consideration the patient’s symptoms, physical examination findings, and diagnostic test results.

5. When to use CPT code 44950

CPT code 44950 should be used when the appendix is inflamed and requires surgical removal. It is important to accurately document the indication for the procedure and ensure that it meets the criteria for reporting this specific code. If the appendix is incidentally removed during another abdominal or pelvic procedure, it should not be separately reported unless there are extenuating circumstances that warrant its identification.

6. Documentation requirements

To support a claim for CPT 44950, the following documentation is required:

• Indication for the appendectomy, specifically the presence of inflammation
• Details of the surgical procedure, including the approach, technique, and any additional procedures performed
• Confirmation of closure of the cut edges of the intestines and absence of bleeding
• Documentation of any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 44950, it is important to ensure that the procedure meets the criteria for reporting this specific code. Incidental appendectomy during intra-abdominal surgery does not usually warrant a separate identification. If necessary to report, modifier 52 should be added. It is also important to follow any specific billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT 44950 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2010, with the description being updated to specify “Appendectomy” instead of the previous description.

9. Examples

1. A patient presents with acute abdominal pain and is diagnosed with acute appendicitis. The provider performs an open appendectomy to remove the inflamed appendix.
2. A patient undergoes a laparoscopic exploration of the abdominal cavity for suspected appendicitis. The provider confirms the presence of an inflamed appendix and proceeds to perform a laparoscopic appendectomy.
3. A patient with a history of chronic appendicitis experiences worsening symptoms. The provider decides to perform an open appendectomy to remove the inflamed appendix.
4. A patient presents with a perforated appendix and signs of peritonitis. The provider performs a laparoscopic appendectomy to remove the appendix and address the perforation.
5. A patient with complicated appendicitis, including the presence of an abscess, undergoes a laparoscopic appendectomy to remove the inflamed appendix and drain the abscess.
6. A patient presents with atypical symptoms, and diagnostic tests reveal a suspicious mass in the right lower quadrant. The provider performs an exploratory laparoscopy, which confirms an inflamed appendix, and proceeds to perform a laparoscopic appendectomy.
7. A patient with a history of recurrent appendicitis experiences another episode of acute abdominal pain. The provider decides to perform an open appendectomy to remove the inflamed appendix.
8. A patient presents with suspected appendicitis, and imaging studies reveal a complicated case with evidence of perforation and abscess formation. The provider performs a laparoscopic appendectomy to remove the inflamed appendix and drain the abscess.
9. A patient with a history of appendicitis presents with recurrent symptoms. The provider decides to perform an open appendectomy to remove the inflamed appendix.
10. A patient presents with right lower quadrant pain and is diagnosed with acute appendicitis. The provider performs a laparoscopic appendectomy to remove the inflamed appendix.