My surgeon is performing a completion proctectomy, abdominoperineal however the patient already has an ileostomy from a previous total colectomy so no stoma or anastomosis will be created. He is just removing the anus and rectum. I will be using teh 45110 as that is he most accurate. Should I append -52 b/c he is not performing the stoma? The concern is that the 52 will cause too much of a reduction in reimbursement. The stoma is the smallest/easiest part of the procedure.

Any thoughts?

Anna Barnes, CPC, CEMC, CGSCS