Basics CPT code 44950, 44960 & 44970

In surgery procedures, their are different techniques used to treat the diseases or diagnosis. Now, the most common are surgeries are performed using laproscopy. Percutaneous surgeries (through the skin) are also one of the techniques used for perfroming angioplasty, thrombectomy, atherectomy procedures. Open surgery is the traditional type of surgery in which an incision is made using a scalpel. In percutaneous  surgery procedure the access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an “open” approach where inner organs or tissue are exposed (typically with the use of a scalpel). Laparoscopic surgery, also referred to minimally invasive surgery (MIS), involves the use of a thin, tubular device called a laparoscope which is inserted through a keyhole incision into the abdomen or pelvis to perform operations that used to require large incisions.

Today we will check the procedure codes used for coding appendectomy exam. Appendectomy can be perfromed by total abdominal incision and by using a laproscope. CPT code 44970 is used for laparoscopy surgical appendectomy. CPT code 44950 is used for removal of appendix (appendectomy) by abdominal incision.

Read also: Hernia repair CPT codes coding guide for coders

Description of CPT code 44950, 44960 & 44970

44970 Laparoscopy, surgical, appendectomy

44979 Unlisted laparoscopy procedure, appendix

The physician performs a laparoscopic appendectomy by placing a trocar at the umbilicus and insufflates the abdomen. The laparoscope is placed through the umbilical port and additional trocars are placed into the abdominal cavity. The appendix is identified, dissected from surrounding structures and its blood supply divided. The appendix is transected with staples or suture and removed. The trocars are removed and the incisions are closed.

44950  Appendectomy

+44955 when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure)

44960  for ruptured appendix with abscess or generalized peritonitis

The physician removes a perforated appendix. The physician makes an abdominal incision. The appendix is identified and mobilized, its blood supply is divided, and the appendix is transected and removed. The abscess cavity is debrided and irrigated. The incision is closed.

44950 and 44960 are for open primary appendectomies; CPT code  44960 is used only for an appendix that has perforated or ruptured, and/or for diffuse peritonitis. The ICD-10 code for that condition is K35.2 (Acute appendicitis with generalized peritonitis).

If a laproscopic appendectomy is performed and the appendix is perforated or ruptured, report 44970. CPT code 44970 is the only code that applies to laparoscopic appendectomy and that it is used to report a laparoscopic appendectomy for either situation – with rupture or without rupture.

Incidental appendectomy is the removal of a clinically normal appendix during non-appendiceal surgery. The American Medical Association (AMA) instructs that an incidental appendectomy during another intra-abdominal surgical procedure should not be reported separately. For instance, AMA states that “it is a misuse of CPT code 44950 (appendectomy) to report it for an incidental appendectomy during the procedure described by CPT code 58150 (Total abdominal hysterectomy, with or without removal of tube(s), with or without removal of ovary(s)). In this case, CPT code 44950 should be bundled into CPT code 58150”.

The add on code +44955 should be used when a major procedure is performed for a medically indicated purpose, for e.g., if the appendix was involved in the disease process and had to be removed.