Mrs.Estrada
New
Hello, I am totally lost 
on how to code this case:
The patient was in the supine position. Ostomy appliance was removed and exam under anesthesia performed; however, the ostomy site was quite tight with carcinomatosis encroaching on the opening. EGD was attempted. A gastroscopy was attempted through the ostomy site and the gastroscope was unable to be passed. Therefore, a 30-French Foley catheter was inserted. Extra holes were cut to allow for improved decompression and this was turned into the diverting loop ostomy's afferent limb. Immediately, 800 mL of liquid stool came out. A 30-French catheter was tapered and then secured to the skin using sutures.
Ostomy appliance was applied. I was present and scrubbed for the entire case and all counts were correct.
FYI: Pt has hx of loop ileostomy creation several months ago
I truly appreciate any and all thoughts on this case
on how to code this case:The patient was in the supine position. Ostomy appliance was removed and exam under anesthesia performed; however, the ostomy site was quite tight with carcinomatosis encroaching on the opening. EGD was attempted. A gastroscopy was attempted through the ostomy site and the gastroscope was unable to be passed. Therefore, a 30-French Foley catheter was inserted. Extra holes were cut to allow for improved decompression and this was turned into the diverting loop ostomy's afferent limb. Immediately, 800 mL of liquid stool came out. A 30-French catheter was tapered and then secured to the skin using sutures.
Ostomy appliance was applied. I was present and scrubbed for the entire case and all counts were correct.
FYI: Pt has hx of loop ileostomy creation several months ago
I truly appreciate any and all thoughts on this case