General Surgery Coding Alert

Question: Our surgeon performed an intracolonic (ileotransverse) bypass. Instead of removing the colon he did this bypass from the ileum to the transverse colon with anastomosis. How should I code the procedure?

Texas Subscriber

Answer: To answer this question accurately, you'll need further information about the approach and bypass construction.

Assuming that this is an open procedure and that the bypass is direct from the ileum to the transverse colon, you could report 44130 (Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy [separate procedure]).

Caveat: The information you provide doesn't specify that this is an open procedure. If this is a laparoscopic procedure, you'll need to use an unlisted code, such as 44238 (Unlisted laparoscopy procedure, intestine [except rectum]).

Your description also doesn't provide a lot of detail about how the surgeon accomplishes the bypass. If the surgeon harvests some small bowel to create the bypass between the ileum and transverse colon, then 44130 doesn't adequately describe the work, and you'll probably need to select an unlisted code.