My surgeon wants to use 44020 for the surgery below but I do not think it is correct. Would you please review and see what you come up with?
DESCRIPTION OF PROCEDURE:
General anesthetic was induced. Abdomen prepped and draped sterily. The previous sutures at the J-Tube, a transverse incision in the left upper quadrant were opened, the fascia of the anterior rectus fascia opened. The fascia was lifted up and the tube insertion site could be visualized. The tacking sutures were taken down. The tube clamped just outside the bowel and then divided just outside the skin. The cut tube was then brought out through the wound. Babcocks were used to bring up the small bowel. We did open the incision a little bit more fully in order to get up without tearing it. There was some bruising about where the sutures had been. I took out the old tube, oversewed the opening there with a figure of eight 3-0 Vicryl, and then imbricated, this taking about eight stitches. Hanestly the bowel distal to it looked somewat dilated as well, however upon placing it back into the abdomen, after having taken downt he tube, it appeared that much of the dilatation was perhaps just from it coursing up to the anterior abdominal wall; the bowel, which was laying flat in the abdomen seeming less distended distally.
I then examined the stomach which was huge. We placed a 14 guage Angiocaht throught a figure of eight, aspirated air and fluid and then tied that down and imbircated that with interrupted 3-0 vicryls, that being on the greater curvature. I then closed the posterior and anterior rectus sheath with running 0 PDS and closed the skin witht running 4-0 PDS.
Thanks for any and all help.
DESCRIPTION OF PROCEDURE:
General anesthetic was induced. Abdomen prepped and draped sterily. The previous sutures at the J-Tube, a transverse incision in the left upper quadrant were opened, the fascia of the anterior rectus fascia opened. The fascia was lifted up and the tube insertion site could be visualized. The tacking sutures were taken down. The tube clamped just outside the bowel and then divided just outside the skin. The cut tube was then brought out through the wound. Babcocks were used to bring up the small bowel. We did open the incision a little bit more fully in order to get up without tearing it. There was some bruising about where the sutures had been. I took out the old tube, oversewed the opening there with a figure of eight 3-0 Vicryl, and then imbricated, this taking about eight stitches. Hanestly the bowel distal to it looked somewat dilated as well, however upon placing it back into the abdomen, after having taken downt he tube, it appeared that much of the dilatation was perhaps just from it coursing up to the anterior abdominal wall; the bowel, which was laying flat in the abdomen seeming less distended distally.
I then examined the stomach which was huge. We placed a 14 guage Angiocaht throught a figure of eight, aspirated air and fluid and then tied that down and imbircated that with interrupted 3-0 vicryls, that being on the greater curvature. I then closed the posterior and anterior rectus sheath with running 0 PDS and closed the skin witht running 4-0 PDS.
Thanks for any and all help.