Wiki Colostomy vs ileostomy

Branham7

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Can I use 44146 if a coloproctostomy is done with an ileostomy?
 
It is up for interpretation and in my opinion its a no. You really have to think about why, and how with clinical practice on this one. What are they doing to the small intestine, are they dividing the distal end near/or terminal Ilium. If they are doing so and dividing the sigmoid-recto junction, wouldn’t that be a total colectomy(44155).
 
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