Wiki Gastrocutaneous fistula


Quincy, MA
Best answers
Findings: Incarcerated percutaneous endoscopic gastrostomy site w/ persistent gastrocutaneous fistula tract. No abscess or intra-abdominal contamination.

OP report states: Once the abdominal cavity was opened the stomach was identified and then grabbed with Allis clamp. Then the PEG site was then transected with the skin and then down to the fascia and down to the stomach where the fistulous and the fistulous tract was completely mobilized and secured then a TA stapler was used to transect the fistula from the anterior stomach wall...Then a quick exploration was performed in the upper abdomen which revealed no significant contamination of the fistulous track into the adominal cavity.

Surgeon coded as 49000 exploratory laparotomy but it doesn't sound like he did a systematic examination of all organs. Any suggestions on how to code? I was thinking maybe 43870 Closure of gastrostomy; surgical.