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AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2024 Issue 3; Ask the Editor

Neobladder Formation

A 66-year-old patient with advanced bladder cancer underwent laparoscopic radical cystectomy, along with formation of an orthotopic neobladder. During surgery, a 55 cm segment of small bowel was selected to form the neobladder. The bowel was divided at both proximal and distal aspects of the neobladder, and the mesentery was incised with care to preserve blood supply to the neobladder. The segment of small intestine was placed towards the pelvis and a side-to-side enteroenteric bowel anastomosis was done. The ureters were then anastomosed to the butt end of the chimney and ureteral stents were placed prior to closure of the anastomosis. The neobladder-urethral anastomosis was completed. The leading edge was brought easily down into the pelvis and anastomosed to the posterior edge of the remaining urethra. The neobladder was then sutured in a modified Studer neobladder fashion. When a neobladder is formed using intestine that is still connected to its original vascular supply, would the correct root operation be Transfer? ...

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