tgenia
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This one has me stumped, any help would be appreciated 
the patient had a whipple procedure cpt 48150. They are being brought back while in global for perforation/breakdown of the anastomosis. Here is the part that is confusing me: ? CPT 47780 or 47785 not sure what duct??
We inspected the area of the choledochojejunostomy. We noted that there was a small amount of bilious output coming from the right medial aspect of the choledochojejunostomy. With futher inspection, we realized that the choledochojejunostomy unfortunately was also approximately 80% disconnected. We decided to re-do this anastomosis since the area of the bowel itself appeared to be very unsuitable for primary repair. We therefore found a suitable window under the jejunum in a spot that would take away the most proximal aspect of the jejunum to included the prior choledochojejunostmy. We fired a blue load of the GIA stapler to transect the bowel and used the ligasure device to disconnect the bowel specimen from its mesenteric connections. We used the very proximal portion of the new jejunal limb which appeared to have a very healthy and thin wall and dedrided the area of the bile duct itself mildly and made a primary anastomosis using 4-0 in a cercumferential fashion. We made the posterior row of anastomosis and then went ahead and placed a biliary tube, which we introduced into the abdomen through a separate stab incision in the right lower flank region along the anterior axillary line, introducing this into the jejunum limb that was going up to the choldochojejunostomy......
Thanks
the patient had a whipple procedure cpt 48150. They are being brought back while in global for perforation/breakdown of the anastomosis. Here is the part that is confusing me: ? CPT 47780 or 47785 not sure what duct??
We inspected the area of the choledochojejunostomy. We noted that there was a small amount of bilious output coming from the right medial aspect of the choledochojejunostomy. With futher inspection, we realized that the choledochojejunostomy unfortunately was also approximately 80% disconnected. We decided to re-do this anastomosis since the area of the bowel itself appeared to be very unsuitable for primary repair. We therefore found a suitable window under the jejunum in a spot that would take away the most proximal aspect of the jejunum to included the prior choledochojejunostmy. We fired a blue load of the GIA stapler to transect the bowel and used the ligasure device to disconnect the bowel specimen from its mesenteric connections. We used the very proximal portion of the new jejunal limb which appeared to have a very healthy and thin wall and dedrided the area of the bile duct itself mildly and made a primary anastomosis using 4-0 in a cercumferential fashion. We made the posterior row of anastomosis and then went ahead and placed a biliary tube, which we introduced into the abdomen through a separate stab incision in the right lower flank region along the anterior axillary line, introducing this into the jejunum limb that was going up to the choldochojejunostomy......
Thanks