How To Use CPT Code 44955

CPT 44955 describes the surgical removal of the appendix during the performance of another major procedure. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44955?

CPT 44955 can be used to describe the surgical removal of the appendix when it is done for an indicated purpose at the time of another major procedure. This code is used when the provider removes the appendix to relieve pain, address active inflammation or scarring from previous inflammation, or prevent rupture. It is important to note that CPT 44955 should be listed separately in addition to the code for the primary procedure.

2. Official Description

The official description of CPT code 44955 is: ‘Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure)’

3. Procedure

1. The provider makes an incision over the right lower quadrant of the abdomen.
2. He enters the abdomen and identifies the appendix.
3. Any pus is suctioned out and the area is washed with saline solution.
4. The provider removes the appendix.
5. The cut edges of the intestines are closed.
6. The provider proceeds to carry out an additional major procedure.

4. Qualifying circumstances

CPT 44955 is performed when the appendix shows evidence of active inflammation or scarring from previous inflammation, or when it needs to be removed to relieve pain or prevent rupture. It is important to note that this procedure is done during the performance of another major procedure, and should not be reported as a separate procedure.

5. When to use CPT code 44955

CPT code 44955 should be used when the provider performs an appendectomy for an indicated purpose at the time of another major procedure. It is important to list this code separately in addition to the code for the primary procedure.

6. Documentation requirements

To support a claim for CPT 44955, the provider must document the following information:

• The need for the appendectomy and the indication for performing it during the other major procedure
• Details of the primary procedure
• Date and time of the procedure
• Incision site and approach
• Findings during the procedure, such as evidence of inflammation or scarring
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 44955, ensure that the appendectomy is performed during another major procedure. This code should be listed separately in addition to the code for the primary procedure. If the appendix appears normal and the removal is incidental, modifier 52, Reduced Services, should be added to the code for the primary procedure.

8. Historical information

CPT 44955 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient undergoes a laparotomy for the removal of a tumor in the colon. During the procedure, the provider identifies an inflamed appendix and performs an appendectomy (CPT 44955) in addition to the primary procedure.
2. A patient with a history of chronic appendicitis undergoes an exploratory laparoscopy for abdominal pain. The provider discovers scarring and inflammation in the appendix and performs an appendectomy (CPT 44955) during the procedure.
3. A patient presents with acute appendicitis and is scheduled for an open cholecystectomy. The provider decides to perform an appendectomy (CPT 44955) during the same procedure to prevent potential complications.
4. A patient with a known appendiceal mass undergoes an exploratory laparotomy for tumor resection. The provider removes the appendix (CPT 44955) during the procedure to prevent future complications.
5. A patient with suspected appendicitis undergoes an exploratory laparotomy. The provider confirms the diagnosis and performs an appendectomy (CPT 44955) in addition to the primary procedure.