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Thread: Fibrin Plug for Enterocutaneous fistula

  1. #1

    Default Fibrin Plug for Enterocutaneous fistula

    AAPC: Back to School
    Repair of enterocutaneous fistula was made with Fibrin Plug.....
    44640 does not seem correct since it seems so involved with bowel mobilization.
    46707 sounds perfect....if it was an anorectal but...it is enterocutaneous.

    Any suggestions?

    PROCEDURE PERFORMED: Fibrin plugging of enterocutaneous fistula.

    PREOPERATIVE DIAGNOSIS: Enterocutaneous fistula.

    POSTOPERATIVE DIAGNOSIS: Enterocutaneous fistula.

    HISTORY: The patient is a pleasant 71-year-old gentleman with a long
    history of enterocutaneous fistula which has failed to resolve with
    conservative management. He is taken to the operating room for a fibrin

    DESCRIPTION: After informed consent was obtained, the patient was taken to
    the operating room and placed supine on the operating room table. After
    general anesthesia had been established, the patient's abdomen was then
    prepped and draped in the standard surgical fashion. The fistula was
    identified. The tract was curetted. A probe was used to identify the
    tract of the fistula itself. We then obtained Surgisis anal fistula plug,
    hydrated it, placed it within the tract without any undue difficulty. I
    then injected fibrin glue around this to help hold it in position. The
    skin overlying the patch was then reapproximate with 3-0 Monocryl suture.
    Vaseline gauze as well as a light pressure dressing was then applied to
    help provide for adequate pressure to hold the plug in place. The patient
    returned to the recovery room, extubated, and in stable condition. The
    patient tolerated the procedure well. There were no complications.

  2. #2


    I have decided to submit billing code 44640 with modifier 52 reduced service. If anyone has any other suggestions I would love to hear them. Thanks in advance. Tracy

  3. #3


    look at 46706

  4. #4
    Join Date
    Apr 2007


    I like 44640. do you have to use the 52 is the question. it states closure but not how?

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