Wiki cecal vs colorectal which dx

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JM.Geyer

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I'm in the need of some coding help. I have a scenerio where a pt comes in and the dictated note states pt was found to have a villous adenoma in the cecum. Then a year later pt had underwent a right hemicholectomy, which revealed the presence of a moderatley differentiated adenocarcinoma arising in a tubulovillous adenoma. I coded this out a 154.3 and 197.8. Now pt is presenting to us denials from her insurance because we didn't use the code 154.0. Should I have used the 154.0 or was I correct in coding the way I did.

Any help would be very helpful.
 
it seems to me that if the portion of the colon removed in the right hemicolectomy was at the end of the sigmoid colon and sigmoid flexure then the 154.0 code would be more accurate because the descriptor for that code is rectosigmoid junctiion. However, if this is not what was removed then the 154.3 would be correct.
 
sjohns827 I did check the orginal op report and the tumor site was noted to be cecum and on the path report it stated tumor site cecum when she had her hemicolectomy
 
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