Unless I missed it, I don't see an ileostomy being created in that note. Instead of a total colectomy code, you might look at one of the partial colectomy codes. You can't use the 44139 add on code with a total colectomy code, only the partial colectomy codes. For the 2 hours of lysis of adhesions, I would add -22 modifier to the colectomy coded and add at least 25 percent to the fee. One of my doctors brought me an article in the ACS Journal about coding component separation during ventral hernia repairs. That article recommends using 15734 for the component separation. I would love to know what other general surgery coders are doing for the component separation procedure.
Any other thoughts?
Susan Smith, CPC
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