can someone plz assist me w/this, dr wants to bill 44625 and 44120 for the op note below. im confused as to yes or no but im leaning more towards yes.. help plz
The patient was taken to the OR and placed on the table in supine position and after adequate anesthesia and OETT was placed. The abdomen was prepped and draped in the usual sterile fashion. The ileostomy was grasped with allis clamp and the bovie was used to dissect the mucosa cutaneous junction free. There was great deal of adhesions in the area. I was unable to get the limbs of the ileostomy free despite multiple maneuvers. The midline incision was then opened and using blunt sharp and cautery dissection was able to free a length of proximal and distal bowel from the ileostomy. This also required resection of a length of bowel due to various serosal injuries. A GIA 75 was used to create a side to side anastomosis and and the top of the anastomosis was closed with a second fire of the GIA. The intervening mesentery was divided using an enseal. Hemostasis was obtained. The anastomosis was placed back inside the abdominal cavity. The fascia of the midline was closed using interrupted 0 vicryls and the fascia of the prior ileostomy site closed using 0 vicryls. The skin was closed using a 3'0 PDS in a pursestring fashion with a penrose in the center and the midline was closed using 4 monocryl and dermabond as a dressing.. The patient tolerated the procedure well
The patient was taken to the OR and placed on the table in supine position and after adequate anesthesia and OETT was placed. The abdomen was prepped and draped in the usual sterile fashion. The ileostomy was grasped with allis clamp and the bovie was used to dissect the mucosa cutaneous junction free. There was great deal of adhesions in the area. I was unable to get the limbs of the ileostomy free despite multiple maneuvers. The midline incision was then opened and using blunt sharp and cautery dissection was able to free a length of proximal and distal bowel from the ileostomy. This also required resection of a length of bowel due to various serosal injuries. A GIA 75 was used to create a side to side anastomosis and and the top of the anastomosis was closed with a second fire of the GIA. The intervening mesentery was divided using an enseal. Hemostasis was obtained. The anastomosis was placed back inside the abdominal cavity. The fascia of the midline was closed using interrupted 0 vicryls and the fascia of the prior ileostomy site closed using 0 vicryls. The skin was closed using a 3'0 PDS in a pursestring fashion with a penrose in the center and the midline was closed using 4 monocryl and dermabond as a dressing.. The patient tolerated the procedure well