AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2017 Issue 2; Ask the Editor

Billroth II (Distal Gastrectomy with Gastrojejunostomy)

A patient found to have a tumor in the distal stomach underwent a distal gastrectomy with gastrojejunostomy (Billroth II). After completion of the distal gastrectomy, the proximal portion of the jejunum was rerouted and attached to the stomach creating a gastrojejunostomy anastomosis. Per guideline B3.1b, procedural steps such as anastomosis of a tubular body part, are not coded separately. When a Billroth II procedure is performed, is it appropriate to assign an additional code for the gastrojejunostomy anastomosis along with the distal gastrectomy? ...

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