maxwell@marshall.edu
Contributor
my physician was doing a Whipple procedure on a patient 48150 when the patient became hypotensive. It was decided to finish the resection and return at a later date for the anastomoses. I decided to use 48150 with 52 modifier for the first surgery but I am having difficulty finding the right codes for the second session.
Section of OP Note:
the proximal jejunum was brought through a window in the right lateral mesocolon to perform our anastomosis. the distal jejunum was sutured to the pancreas. a small hole was made in the duodenum on the anterior mesenteric side. a mucosa to mucosa anastomosis between the pancreatic duct and the duodenum was performed using a 5-0 PDS suture, and then an anterior layer of 3-0 silk sutres was again used approximate the pancreatic casule to the duodenum. then, 10 cm distal to this, a hepaticojejynostomy was performed using interrrupted 5-0 PDS sutures after cleaning ends of the common bile duct. lastly, again 10 cm distoal to the hepaticojejynostomy, a gastrojejunosomy was performd. a posterior layer of 3-0 silk sutures was placed, enterotomies were made, a handsewn anastomosis was performed using 3-0 running PDS surture, and the serosa was then approximated anteriorly using 3-0 silk sutures. JP drains were placed next to the pancreaticojejunostomy and hepaticojejunostomy. the abdomen was again irrigated with normal saline. the fascia was closed using a running.......
Any help would be greatly appreciated!!!
Section of OP Note:
the proximal jejunum was brought through a window in the right lateral mesocolon to perform our anastomosis. the distal jejunum was sutured to the pancreas. a small hole was made in the duodenum on the anterior mesenteric side. a mucosa to mucosa anastomosis between the pancreatic duct and the duodenum was performed using a 5-0 PDS suture, and then an anterior layer of 3-0 silk sutres was again used approximate the pancreatic casule to the duodenum. then, 10 cm distal to this, a hepaticojejynostomy was performed using interrrupted 5-0 PDS sutures after cleaning ends of the common bile duct. lastly, again 10 cm distoal to the hepaticojejynostomy, a gastrojejunosomy was performd. a posterior layer of 3-0 silk sutures was placed, enterotomies were made, a handsewn anastomosis was performed using 3-0 running PDS surture, and the serosa was then approximated anteriorly using 3-0 silk sutures. JP drains were placed next to the pancreaticojejunostomy and hepaticojejunostomy. the abdomen was again irrigated with normal saline. the fascia was closed using a running.......
Any help would be greatly appreciated!!!