AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 2; Ask The Editor

Reversal of Roux-En-Y Bypass

A patient presented for reversal of a Roux-en-Y gastric bypass. Trocars were placed, the roux limb was identified and traced up to the gastric pouch and dissected off the omentum on either side of the excluded stomach posteriorly. Via laparoscopy, the gastric pouch was dissected above the gastrojejunostomy and the roux limb was dissected down and out of the field. At this point, the gastric pouch would reach nicely to the excluded stomach in the natural anatomic position. The anastomosis was then checked for leaks via endoscopy. Attention was then turned to the pylorus for the pyloromyotomy. The pylorus was transected from the stomach down into the duodenum, pulled transversely and reclosed. Next, the G-tube was placed into the stomach through the anterior abdominal wall. The Roux limb was then dissected down off the transverse colon and a complete reversal of the small bowel portion of the anastomosis was completed. Approximately 30 cm of the end of the Roux limb had to be resected due to devascularization. The new end of the Roux limb was anastomosed with the biliary limb creating two jejunostomies. What are the procedure codes for reversal of a Roux-en-Y? ...

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