Mobilization of sigmoid Colon with mobilization of splenic flexure laparoscopically and partical resection of colon with diverting colostomy.
I have 44213 (but this is an add on code to another) 44140 or 44320
Laparoscope was introduced, grasp colon and mobilized it around the splenic flexure. With the cancer present to the rectal stump, no good dissection plane was preformed.
Vertical midline incision was made below umbilicus down to the pubic symphysis. we opened the peritoneal line of the incision and perform a loarge amount of blunt dissection. a significant mesenteric involvement but felt that we were able to transect the rectum with green load and transected proximal to the mass. took down the adjoining messentery and removed the specimen. An incision where the patient had previously marked ostomy by nurse. made elliptical incision, down to fascia and opened in cruciate form. placed 2 fingers through the ostomy incision. delivered the proximal colon up to the skin level.
Any assistance would be greatly appreciated. Thank you
Amy, CPC-H CCP-H