Wiki Partial Colectomy with delayed colostomy due to complication

TnRushFan

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Any guidance will be greatly appreciated...

My surgeon took a patient to the OR and completed partial colectomy of the transverse and descending colon. The patient began having cardiac issues and the operation had to be halted prior to any anastomosis or stoma creation. They covered his open abdomen with a negative pressure dressing and towels and placed a drain then an airtight seal.

The next day he was taken back to the OR - negative pressure dressings removed and abdomen explored. They performed partial omentectomy, created end colostomy and matured it. the abdominal wound was packed with wet Kerlix and ABD pads.

Should I use code:
Day 1:
44141 with -53 to indicate the discontinuance of the initial procedure?
44139 mobilization of splenic flexure (clearly documented in op note)
97607 for negative pressure dressing

Day 2:
44320-58 or 44141-52-58 for the colostomy creation for?
49255 for omentemtectomy day 2?

Thank you in advance
 
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