tci General Surgery Coding Alert - 2011 Issue 1

You Be the Coder: 537.4 Trumps V55.1 for Old PEG Site

Question:Our surgeon closed a "gastrocutaneous fistula," which is actually the site of an old PEG tube that has been removed. The patient has intermittent drainage of gastric contents. With the patient under general anesthesia, the surgeon dissected the fistula tract from the surrounding subcutaneous tissue and fascia, ligating the juncture with the stomach and removing the tract before suturing the fascia and subcutaneous tissue. What are the correct diagnosis and procedure codes?Texas SubscriberAnswer:An appropriate diagnosis code would be 537.4 (Fistula of stomach or duodenum). You should report the procedure as 43870 (Closure of gastrostomy, surgical).You should...

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