Gastroenterology Coding Alert

Question: Our gastroenterologist recently performed an exploratory laparotomy, liver biopsy, gastrojejunostomy with placement of a gastrostomy and jejunostomy tube along cholecystojejunostomy on a 55-year-old patient. The procedure notes read, "A midline incision was performed and carried through skin and subcutaneous tissue. The peritoneal cavity was entered. Upon entering the abdomen, he was found to have multiple small liver metastases involving both lobes of the liver. A small wedge biopsy of the liver was performed to encompass a nodule that was located at the very surface of the left lateral segment of the liver. Cautery was used for hemostasis. He had a mass on the pancreas, swollen gallbladder. I decided to bypass his stomach with the gastrojejunostomy, and bring up a loop of small bowel in order to perform cholecystojejunostomy, since his common bile duct was not enlarged. Instead of passing a single tube, the decision was made to place both [...]