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  • Posted by 32779, 1 year ago. There are 3 posts. The latest reply is from 32779.
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  1. Dr did a laparotomy with bx of mesentery, resection of carcinoid neoplasm with primary resection of ileum with anastomosis.

    Upon midline incision, a large neoplasm sitting in the mesentery. taking down the mesentery, there was small bowel hooked into this area as well as other pieces of the mesentery. There was a separate piece of mesentery that was involved and it was excised and sent to path, and then this large neoplasm which was hooked posterior to the duodenum had to be peeled away. Once we resected this, it was sitting right on the superior mesenteric artery, which we avoided injury to and had to take one of the larger meseteric veins. Then there was direct extesion to a piece of small bowel, which we resected and primary anastomosis distal to the ileum. Besides 44120 for small bowel resection, what else should I be coding. 44160 does not seem to apply here and exploratory lab would be bundled?

  2. The correct coding for this case is simply 44120 (Enterectomy, resection of small intestine; single resection and anastomosis).

    The surgeon removed only one carcinoid bowel section. If the patient had multiple carcinoid(necrotic) bowel sections and the surgeon removed each section, you would report +44121 (... each additional resection and anastomosis [list separately in addition to code for primary procedure]) for each subsequent section.

    35221 is to be reported if any repair done in mesenteric vein.

  3. Thanks for your help!

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