Wiki Laparotomy with resection of anterior gastric all ulcers

[laura_clffrd@yahoo.com]

58 pt w/ perforated gastric ulcer.
An upper mid-line incision was made and the abdomen was easily explored through this. The stomach looked fairly healthy, no other potential etiology was found in the douodenum, small bowel and colon, or liver. I resected the site, which included the ulcer, with the large clips and found an adjacent, fairly deep ulcer, somewhat more supermoedially. The second ulcer with clips in it, further distally, was also resected locally. The stomach was closed at each site in 2 layers with vicryl and silk lemberts. the anesthesiologist placed a nasogastric tube and I manually directed it into the stomach.

Pt had endoscopy the day before and clips were placed on the ulcers.

Can I do something w/ 49010, 43610 X2 ?

Thanks!

 

[Lujanwj]

I wouldn't use Units (x2). Not sure if malig or benign so maybe:
4361*
4361*-59 (or -76 depending on payer)

Remember, Exploration can not be used if a definitive procedure was done e.g. excision of ulcer, resection colon, suture of small bowel, etc... They are usually (separate procedures) which includes it in the more extensive procedure.


Good Luck!