Question

Assign the ICD-10-CM code(s) to diagnoses and conditions and assign the CPT surgery code(s) and the appropriate HCPCS level II and CPT modifier(s). Do not assign ICD-10-CM external cause codes.

PREOPERATIVE DIAGNOSIS: Acute appendicitis. POSTOPERATIVE DIAGNOSIS: Acute suppurative appendicitis. PROCEDURE: Appendectomy. OPERATIVE FINDINGS: The patient was found to have an acute appendicitis, very high, going up under the cecum. No adenopathy was noted, and because we did run into infecting material, we did not look for a Meckel's diverticulum or do any other exploring. With the patient under satisfactory general endotracheal anesthesia in a supine position, the abdomen was prepared with pHisoHex and draped with sterile drapes. A linear incision about 5 or 6 cm long was made in a transverse manner in the right lower quadrant over McBurney's point. The subcutaneous tissues were divided; bleeding points were picked up with hemostats and ligated with 4-0 Vicryl ligatures. The external oblique aponeurosis was divided down in the direction of its fibers, the internal oblique muscle and transversalis fascia were divided in the direction of their fibers, and the peritoneum was opened. We had trouble getting the omentum away from the appendix and a little trouble finding the appendix since it was retrocecal. However, we were able to find it and deliver it through the wound. The mesoappendix was clamped with Kelly clamps down the base of the appendix and divided and doubly ligated with 2-0 Vicryl ligatures. The base of the appendix was doubly ligated with 2-0 Vicryl ligatures, the appendix was removed between Kelly clamps, and the base of the appendix was cauterized with phenol and alcohol and inverted with a purse-string suture. A search for bleeding then failed to reveal any. Sponge counts and instrument counts were verified. The peritoneum was closed with a continuous suture of O PDS; the internal oblique muscle and transversalis fascia were washed with a Hibiclens solution and closed with interrupted 0 POS

Answer 1

Ans) K35.80
K35. 80 Acute suppurative appendicitis (disorder)

- When a surgeon performs a primary appendectomy, meaning that removal of the appendix was the sole reason for the surgery, choose one of these CPT® codes: 44950, Appendectomy. 44960, Appendectomy; for ruptured appendix with abscess or generalized peritonitis. 44970, Laparoscopy, surgical, appendectomy.

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