ileocolostomy

[kingkong]

If any part of the small bowel is removed and anastomosed to the colon would I code 44160/44205 or are these codes used ONLY when the terminal ileum is removed and anastomosed to colon??

 

[jewlz0879]

Per code description: A segment of colon and terminal ileum is removed and an anastomosis is performed between the remaining ileum and colon.

What about 44120/44202, depending on if done Lap or Open?

I just started coding for General Surgery so this stuff is fairly new to me as well. Any other input is appreciated.

 

[koatsj]

If the small bowel was resected, you would use 44120 for open and 44202 for lap.

 

[Lujanwj]

Not exactly sure what your question is. The terminal ileum doesn't have any anatomical markers aside from it being terminal. Terminal ileum just means the end of the ileum -nothing more, nothing less.

Scenarios and codes that might help you.

Dr resecting the ileum and does ileum to ileum anastomosis *ileoileostomy (sometimes referred to enteroenterostomy)* (44120/44202). Can also use this code for anastomosis of duodenum, jejunum and/or ileum.

Dr resecting ileum and cecum/colon and doing ileum to colon anastomosis *ileocolostomy*(44160/44205)? Must resect some colon to use this code.

Dr resecting ileum only and anastomosing to the cecum *ileocecostomy* (44120-22/44202-22 or Unlisted -subject to opinions)

Dr resects sigmiod and anastomosis it to the rectum *coloproctostomy* (44145/44207)

If NO resection and a side-to-side anastomosis of Ileum to Colon *enteroenterostomy* (44130/44238)

 

[colorectal surgeon]

44160 would not be the only code. Don't forget about 44150 where the entire colon is removed and the ileum is anastomosed to the rectum.

 

[Lujanwj]

Actually, 44150 is an ileoproctostomy not an ileocolostomy. Don't forget the colon and rectum are two different things.

 

[acf7575]

What code would you use when the provider resects that surgically created ilecolostomy from the already done 44160 (Colectomy, partial, with removal of terminal ileum with ileocolostomy). This is no removed for malignancy along with two areas of small intestine (44120 and +44121) en block. Can you use the 44160 as I believe Medicare has a once in a lifetime rule? What other code would be useable, unlisted?