l1ttle_0ne
Guru
Can anyone provide their opinion on this case?? A colostomy revision was done, but also part of the colon was removed also. I'm kind of unsure what code to use. The doctor wants to charge for a 44141 which is Colectomy, partial; with skin level cecostomy or colostomy. But I don't think that is appropriate. I've seen something where it's recommended to do 44140-52 because this was a partial colectomy without anastomosis, and 44340-59. If someone could please give their opinion it would be a great help to me. I'm unsure of what to do. Thank you!
PREOP DX: Colostomy prolapse
POSTOP DX: colostomy prolapse, colon polyp
SURGEON:
OPERATIVE PROCEDURE:
1. Colostomy revision with partial colectomy
FINDINGS: Colostomy, which was the proximal transverse colon, was prolapsed 10 cm. The colostomy was mobilized and transected; large, hard polypoid lesion noted in the distal colon- likely a lead point. End colostomy created with the proximal transverse colon. No complications
DESCRIPTION OF PROCEDURE: The patient was taken to the operating room and given sedation Perioperative antibiotics given. Local anesthetic given. Circular incision made at the mucocutaneous junction. Colon cleared from subcutaneous tissue with cautery. Colon was then eviserated. The colon was cleared from the mesentery with clamp and ties. The colon, proximal to where it was prolapsing, was then transected with cautery. The colostomy was matured with 2-0 and 3-0 chromic sutures
EBL: 50 ml
SPECIMENS: proximal transverse colon
PREOP DX: Colostomy prolapse
POSTOP DX: colostomy prolapse, colon polyp
SURGEON:
OPERATIVE PROCEDURE:
1. Colostomy revision with partial colectomy
FINDINGS: Colostomy, which was the proximal transverse colon, was prolapsed 10 cm. The colostomy was mobilized and transected; large, hard polypoid lesion noted in the distal colon- likely a lead point. End colostomy created with the proximal transverse colon. No complications
DESCRIPTION OF PROCEDURE: The patient was taken to the operating room and given sedation Perioperative antibiotics given. Local anesthetic given. Circular incision made at the mucocutaneous junction. Colon cleared from subcutaneous tissue with cautery. Colon was then eviserated. The colon was cleared from the mesentery with clamp and ties. The colon, proximal to where it was prolapsing, was then transected with cautery. The colostomy was matured with 2-0 and 3-0 chromic sutures
EBL: 50 ml
SPECIMENS: proximal transverse colon