Wiki Sigmoid colectomy with colostomy reversal

[m040781]

Hi,

I need to bill a laporoscopic sigmoid colectomy with colostomy reversal. I am looking at 44227, but does that include the colectomy? Or do I need 44204 and 44227? Thank you!

 

[nickelclaw]

if anastomosis was done with a synchronous resection (take-down/closure enterostomy w/resection) per lap then yes 44227
and it includes the closure of colostomy, and resection with anastomosis. See the coder desk reference below:
44227
The physician takes down (closes) a previously created enterostomy (stoma) of the large or small intestine using a laparoscope. With the patient under general anesthesia, the physician places a trocar at the umbilicus into the abdomen and insufflates the abdominal cavity. The physician places a laparoscope through the umbilical incision. Additional trocars are placed, through which the specialized surgical instruments are inserted. The stoma is mobilized and taken down from the abdominal wall. The stoma is resected and the bowel ends are reapproximated with staples or sutures. The laparoscope is removed, the ports are closed with incisions, and the stoma is matured.

per nosology AHA coding clinic 1st quarter, 2009 pg 5
Closure of a colostomy involves minor trimming of the colon edges prior to anastomosis. The trimming and end to end anastomosis are included in the closure code.
If further resection or anastomosis other than the end to end is performed, an additional code for the colectomy as well as the anastomosis may be assigned.

 

[m040781]

Thank you!