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Thread: reversal of ileostomy and mucus fistula

  1. #1
    Join Date
    Apr 2007

    Cool reversal of ileostomy and mucus fistula

    AAPC: Back to School
    I have a case where a patient is having an ileostomy reversed without an additional resection of intestine, but an anastamosis is done (ileocolostomy). In addition, in the same op session, the patient is having the fistula reversed with a coloproctostomy. No additional segment of intestine is removed, however, due to the length of intestine the splenic flexure needs to be mobilized. I have read that if you do not resect additional intestine you can't charge44625/44626? Is this correct? You can't use the add on code for the mobilization, correct? How would you code this? Thanks!

  2. #2
    Join Date
    Apr 2007


    I would like to read the op note.

    44620 describes closure of enterostomy, large or small, without resection. That may apply.

    I would bet to close the mucous fistula an additional segment will have to be resected and then 44625 will apply. Hope this helps.

  3. #3
    Join Date
    Apr 2007


    +44139 is not a PX for 44620, so cannot be additionally reportable see page 236

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