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The excision of a lesion of the mesentery, as described by CPT® Code 44820, refers to a surgical procedure targeting the mesentery, which is a vital structure in the gastrointestinal tract. The mesentery is a fan-shaped fold of tissue that supports the intestines and contains essential blood vessels, lymphatics, and nerves that supply the intestinal organs. Lesions or tumors that may develop in the mesentery can vary in nature, being either cystic or solid, and can be classified as benign or malignant. During the procedure, an incision is made in the abdomen to access the mesentery, allowing the surgeon to carefully examine the area for any additional masses or abnormalities that may not have been previously identified. Once the lesion is located, it is excised along with a margin of healthy tissue to ensure complete removal and minimize the risk of recurrence. The excised tissue is then sent to a laboratory for pathological evaluation, which is crucial for determining the nature of the lesion. After the excision, the surgical site is irrigated to prevent infection, bleeding is controlled, and the incisions are closed to promote healing.
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The excision of a lesion of the mesentery is indicated for various conditions that may affect the mesenteric tissue. These indications include:
The procedure for excising a lesion of the mesentery involves several critical steps, which are outlined as follows:
After the excision of the mesenteric lesion, patients are typically monitored for any immediate complications. Post-procedure care may include pain management, monitoring for signs of infection, and ensuring proper recovery. Patients may be advised on dietary modifications and activity restrictions during the initial recovery phase. Follow-up appointments are essential to assess healing and to discuss the results of the pathological evaluation of the excised tissue.
| Short Descr | EXCISION OF MESENTERY LESION | Medium Descr | EXCISION LESION MESENTERY SEPARATE PROCEDURE | Long Descr | Excision of lesion of mesentery (separate procedure) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 96 - Other OR lower GI therapeutic procedures |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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