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resection w/colostomy and ileostomy

  1. #1
    Default resection w/colostomy and ileostomy
    Medical Coding Books
    Need help!

    Doc says they want to use 44206, don't think I agree. It was done laparoscopically. So here's part of the note:

    Sigmoid was taken down from the peritoneal reflection in the pelvis to the left colon and removed between GIA staple lines. The distal colon had normal mucosa actually at the rectum for about 4 cm, and then promplty a stricture was noted moving proximally when examining the colon off the operative field. .....a left colostomy was then created (descending colostomy) in a standard manner and matured primarily. The diverting loop ileostomy was created in the right mid abdomen at the trocar site.

    I'm having a tough time deciding on this one, but I don't see the 44206 in this. I dunno. Help!

  2. #2
    44206 would be correct, it is a heartmann type procedure. Also report 44187 for the diverting loop ileostomy. There are no CCI, bundling issues with that.


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