CPT coding for Open Right colectomy with end ileostomy

MarylouT

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Hello: Our surgeon performed an open right colectomy with end ileostomy. Normally for a right colectomy, we would use 44160 and the use 44310 for creation of an ileostomy However, 44160 states that an anastomosis is performed. With an end ileostomy, no anastomosis is performed. Also, this is a Medicare patient, so the use of the 52 modifier (reduced services) with 44160 will be denied. I would appreciate any assistance with coding this.

Jodi Dibble: thanks for responding - having issues with my scanner, so here's the portion of the Op Report that indicates procedures: ...We were using LigaSure Impact after transecting terminal ileum and the transverse colon distal to the tumor...we brought out the end ileostomy through premarked ostomy site...

So, Surgeon technically did open right colectomy with removal of terminal ileum, but did not perform anastomosis between the remaining ileum and colon. Instead, he brought out the end ileostomy through a premarked ostomy site. The issue is - can I use 44160 even though no anastomosis was performed? Thanks for any assistance you can give me.
 
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lindsey.hansen

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I would code it as a 44160-52 w/ the ileostomy, and if it gets denied I believe just sending in the notes underlining why is sufficient for them to pay. At least that's what we do.
 
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