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Thread: Sigmoid colon resection with rectal pouch & colostomy/Stryker irrigation of abdomen

  1. #1

    Default Sigmoid colon resection with rectal pouch & colostomy/Stryker irrigation of abdomen

    AAPC: Back to School
    Just want to confirm that this was coded correctly. Please provide any thoughts. (44146)Thanks.

    ...The midline incision was made in the lower abdomen and carried out through subcutaneous tissues. The peritoneal cavity was entered. Free air was appreciated immediately. There was fecal contamination and purulent material. Cultures were taken. The area in question was isolated, which was on the anterior aspect of the sigmoid colon. The patient did have moderate diverticular disease as well. The sigmoid colon was divided in approximately its mid section with a GIA stapling device. The mesentery was then taken down between clamps and suture ligated with 2-0 silk suture. The mesentery was taken down to beyond the point of perforation. The TA 60 was then fired across the bowel. Two-0 Prolene suture was utilized to mark the end of the bowel to allow for ease with ultimate reanastomosis. Following this, the abdomen was then thoroughly irrigated with the Stryker irrigator using of approximately 2-1/2 L of antibiotic containing solution. The Jackson-Pratt drain was then placed via a separate stab incision. The bowel was brought out through an ostomy site in the left lower quadrant. The fascial sutures of 3-0 silk were then utilized extensively circumferentially on the colon. The midline incision was closed with running double stranded PDS suture. Clips were applied to the skin. A Tegaderm dressing was applied. The ostomy was then opened and immature with 3-0 Vicryl everting suture....

  2. #2
    Join Date
    Apr 2007


    Actually this is 44143.

    44146 is when an anastomosis is done and a colostomy to protect the anastomosis.

    44143 is a Hartmann resection when only a colostomy is done and the distal end is closed.

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