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AAPC CPC Exam - Topic 17 Question 58 Discussion
Topic #: 17
A patient is seen at the doctor's office for nausea, vomiting, and sharp right lower abdominal pain. CT scan of the abdomen is ordered. Labs come back indicating an increased WBC count with review of the abdominal CT scan. The physician determines the patient has a ruptured appendicitis. The physician schedules an appendectomy and takes the patient to the operating room. The appendix is severed from the intestines and removed via scope inserted through an umbilical incision. What CPT and diagnosis codes are reported?
Procedure Coding:
44970 -- Laparoscopic appendectomy
Appendix removed via scope through umbilical incision, confirming laparoscopic approach
Diagnosis Coding:
K35.32 -- Acute appendicitis with perforation and localized peritonitis, without abscess
Documentation supports ruptured (perforated) appendicitis
No abscess documented
Why Other Options Are Incorrect:
B -- Signs/symptoms (R11.2, R10.31) not coded once definitive diagnosis is established
C -- 44960 = open appendectomy (not performed)
D -- 44950 = open appendectomy, diagnosis code incorrect
ICD-10-CM Guideline Reference:
Do not code symptoms when a definitive diagnosis is confirmed.
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