Partial Colectomy without anastamosis or end colostomy

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I am looking for the correct way to code for a Sigmoidectomy with partial excision of the Terminal Ileum. They did not do the anastamosis or create the stoma due to abdominal contamination. My thought was to use 44160 with modifier 52 for reduced services due to no anastamosis or ileocolostomy. It has been suggested to use modifier 58 on both the 44160 (for the initial surgery) and also on 44141 when he returns to the OR for additional resection of the left colon with anastamosis and colostomy a few days later.
 

cwpierce

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I would code using the 52 due to leaving the the intestine in a state of discontinuity. Use -58 when the physician comes back to either do a colostomy or anastamosis of the discontinuity.
 

cmartin

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When they do the expected completions w/i a couple of days, at the "2nd look" procedure, I usually bill the first date for the complete procedure and the 2nd date just the 2nd look w/the 58. For instance if he resects 2 separate sections of small intestine & does a "clip & drop" on day one, and at the 2nd look on day 3 he does 2 anastomoses to complete the 2 sbr w/anasts, I would bill 44120 & 44121 for day 1, and 49002-58 for day 3.
 

LindaEV

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This is really a case by case issue, but I'm on track with CMartin. If they are simply "finishing up" a procedure the next day or so, I simply bill the complete procedure on one date of service.

In your case, I agree with the 44160-52 and then the 44141-58 for the second procedure.(based in what you're saying...of course no guarantees without a complete op :))
It would not be appropriate to use a -58 on the initial surgery.
 
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