The first procedure, the pt. came in and had the cecum and ileum removed laparoscopically, I got 44205 for this, then the pt. came back for a "second look laparotomy, resection of a small portion of ascending colon with re-anastomosis". The procedure note from this one partially states: "the ascending colon actually had a region of necrosis, which was re-resected in a primary anastomosis as the margins were now clear, was created. The mid-ileum to ascending colong anastomosis was completed with a GIA stapler. The defect was closed with a TA stapler". I'm not sure what code to use for this one, and then the pt. came back again, for "re-closure of abdominal wound." in which they examined the wound, then "number 2 nylon retention sutures were placed and looped PDS suture was utilized to approximate the fascia of the wound. Retention sutures were knotted over bolsters".

These were all done within a few days of each other, and I'm not sure how to code all of this. It's a little bit frustrating! I've only been doing general for a few months, and this is the first time I've had one like this. Any help is greatly appreciated! :0)