esploratory lap with drainage of peritoneal contamination

MSUEEMBRY

Guest
Messages
31
Location
Barren River
Best answers
0
exploratory lap with drainage of peritoneal contamination

Please help me code this op note. I am having a lot of trouble with CPT codes

PROCEDURE NAME EXPLORATORY LAPAROTOMY AND DRAINAGE OF PERITONEAL CONTAMINATION, NEAR TOTAL GASTRECTOMY, REVISION OF PROXIMAL POUCH OF THE ROUX-EN-Y GASTRIC BYPASS AND REANASTOMOSIS

Under general anesthesia pper midline incision was made, the abdomen was opened and full of murky, dark fluid thoughout all quadrants of the adbomen and pelvis, these were all washed out with saline solution and aspirated out.

the liver was normal, minimal adhesions were taken down between small bowel and abdominal wall. It was clearly a 5mm perforation of the anastomotic ulcer and the treatment is removal of the distal gastric remnant.

the excluded stomach was mobilized, Splenogastric vessels taken down, right gastric and gastroepiploic arteries were taken down with harmonic scalpel beyond the pylorus. The duodenum was transected with GIA stapler.

The Roux limb was traced to just belw the gastrojejunal asastomosis, just below the perforation, about 3 cm inferiorly, the Roux limb was transected with GIA stapler.

The proximal gastric stomach was dissected. The phrenoesophageal ligament was taken down getting around the proximal gastric pouch and a new pouch created transecting the old gastric pouch about 4 cm below the GE junction. The old anastomosis along with the rest of the stomach with distal gastric pouch was removed.

The Roux limb was brought up to the gastric pouch and reanastomosed in 2 layers, making the stoma about the size of 12 MM. air test was normal with no bubbles.

Small bowel was traced, the jejunojejunal mesenteric defect was open and this was reclosed. Drains were brought out on either side of the abdomen.

any help coding this would be greatly appreciated!
 
Last edited:
Top