tci General Surgery Coding Alert - 2013 Issue 7

Reader Question: Watch for Extra Services With Colectomy

Question: Please help with coding the following case: Made midline abdominal incision, mobilized ileocecal junction, mobilized splenic flexure, divided terminal ileum proximal to obstruction, divided and ligated ascending colon. Mobilized rectosigmoid junction, divided upper rectum and distal sigmoid junction. End to end anastomosis created, circular opening made for ileostomy with stapled end of ileum pulled through. French blake tube placed into pelvis through separate stab wound, secured to skin at exit site, stoma bag applied. Pennsylvania Subscriber Answer: The best code for this case is 44145 (Colectomy, partial; with coloproctostomy [low pelvic anastomosis]). The surgical note documents an ileostomy...

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