Favetville, North Carolina
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After general anesthesia patient in the supine position on fluoroscopic table a dual channel duodenoscope was advanced to the level of the second portion room second worsening duodenal bulb and normal appearance. Antrum ulcer normal appearance. Gastric sleeve was appreciated as well. The leak was visible at the just distal to the junction of the GE junction and the gastric sleeve anastomosis. There was fluid coming out the leak. Leak was approximately 1 cm in diameter.

At this point then we burned the edges of the mucosa of the leak with APC followed by D epithelialization with a cytology brush. The scope was then removed and a overstitch device was then attached for we then performed 2 running sutures across the leak. Each suture was characterized by approximately 6 running stitches. After the deployment of the second suture the leak was visibly closed. We did not see any further fluid emanating out of the leak. The scope was then removed and the overstitch device was detached for further visualization and again there was no fluid emanating out of the leak and this suture appeared to be completely closed.

For further reinforcement of and to ensure leak closure we then advanced a 0.38 wire into the gastric antrum followed by removal of the scope. Before moving scope we did mark the level of the leak with a Hemoclip that was taped to the patient's gown. We then deployed a partially covered 23 mm diameter by 210 cm long esophageal stent. Stent was deployed under fluoroscopic and endoscopic view. A biopsy forcep was also utilized to finally adjust the stent. The distal portion stent was within the distal gastric sleeve proximal to the gastric antrum. The proximal portion stent was at 30 cm above the GE junction. The stent appeared to be in excellent position at this point then the procedure was ended.

What code should i code for this procedure? I thought 43266 for stent which is a out of numeric code.