How To Use CPT Code 44970

CPT 44970 refers to a laparoscopic surgical appendectomy procedure. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT code 44970.

1. What is CPT 44970?

CPT 44970 is a medical code used to describe a laparoscopic surgical appendectomy procedure. This code is utilized when a healthcare provider removes the appendix using a minimally invasive laparoscopic technique due to an inflamed or burst appendix.

2. 44970 CPT code description

The official description of CPT code 44970 is: “Laparoscopy, surgical, appendectomy.”

3. Procedure

The 44970 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes three small incisions in the abdomen, one around the umbilicus and two in the lower abdomen.
3. The peritoneal cavity is inflated with carbon dioxide gas.
4. A scope is inserted through the umbilical incision for visualization.
5. Trocars and additional ports are inserted into the incisions.
6. Adhesions are divided, and the appendix is severed from the intestine.
7. The appendix is removed with forceps placed through a trocar.
8. A surgical stapler is inserted through a trocar and closes the area where the appendix was removed.
9. The abdomen may be irrigated with saline and/or antibiotic solution and suctioned out.
10. The trocars and instruments are removed, bleeding is checked, and the abdominal incisions are closed with sutures or staples.

4. Qualifying circumstances

Patients eligible to receive CPT code 44970 services are those who have been diagnosed with an inflamed or burst appendix, which requires surgical intervention. The healthcare provider must determine that a laparoscopic appendectomy is the most appropriate treatment option for the patient based on their medical history, physical examination, and diagnostic findings.

5. When to use CPT code 44970

It is appropriate to bill the 44970 CPT code when a healthcare provider performs a laparoscopic surgical appendectomy due to an inflamed or burst appendix. The provider must have determined that this minimally invasive procedure is the most suitable treatment option for the patient.

6. Documentation requirements

To support a claim for CPT 44970, the following information needs to be documented:

• Patient’s medical history and physical examination findings
• Diagnostic test results confirming the inflamed or burst appendix
• Rationale for choosing a laparoscopic appendectomy as the treatment option
• Detailed description of the procedure, including the steps performed and instruments used
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 44970, it is essential to follow the specific guidelines and rules set by the payer. Some tips for billing this code include:

• Ensure that the documentation supports the medical necessity of the laparoscopic appendectomy
• Verify that the patient’s diagnosis aligns with the qualifying circumstances for CPT 44970
• Check for any additional codes that may apply to the patient’s case, such as anesthesia or postoperative care codes
• Review the payer’s policies for any specific requirements or restrictions related to CPT 44970

8. Historical information

CPT 44970 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Similar codes to CPT 44970

Five similar codes to CPT 44970 and how they differentiate from CPT 44970 are:

1. CPT 44950: This code refers to an open appendectomy procedure, which involves a larger incision and a more invasive approach than CPT 44970.
2. CPT 44955: This code is used when an open appendectomy is performed in conjunction with another surgical procedure, whereas CPT 44970 is solely for a laparoscopic appendectomy.
3. CPT 44960: This code describes an open appendectomy with drainage of the peritoneal abscess, which is not included in CPT 44970.
4. CPT 44979: This code is for a laparoscopic appendectomy with the removal of a foreign body, while CPT 44970 does not involve foreign body removal.
5. CPT 44980: This code refers to a laparoscopic appendectomy with drainage of the peritoneal abscess, which is not part of CPT 44970.

10. Examples

Here are 10 detailed examples of CPT code 44970 procedures:

1. A 25-year-old patient presents with acute appendicitis and undergoes a laparoscopic appendectomy.
2. A 40-year-old patient with a history of abdominal pain is diagnosed with a ruptured appendix and undergoes a CPT 44970 procedure.
3. A 30-year-old patient with a gangrenous appendix undergoes a laparoscopic appendectomy to prevent further complications.
4. A 35-year-old patient with a perforated appendix and localized peritonitis undergoes a CPT 44970 procedure.
5. A 45-year-old patient with a history of recurrent appendicitis undergoes a laparoscopic appendectomy as a definitive treatment.
6. A 50-year-old patient with an inflamed appendix and multiple adhesions undergoes a CPT 44970 procedure to remove the appendix and divide the adhesions.
7. A 20-year-old patient with a history of right lower quadrant pain is diagnosed with acute appendicitis and undergoes a laparoscopic appendectomy.
8. A 55-year-old patient with a ruptured appendix and localized abscess undergoes a CPT 44970 procedure with additional drainage of the abscess.
9. A 60-year-old patient with a history of chronic appendicitis undergoes a laparoscopic appendectomy as a definitive treatment.
10. A 28-year-old patient with a gangrenous appendix and localized peritonitis undergoes a CPT 44970 procedure to remove the appendix and treat the peritonitis.