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General Surgery Coding Alert

Reader Question:
44208 Means Colostomy

Question: Our surgeon performed a laparoscopic low-anterior colon resection with a diverting ileostomy. Is 44208 the correct code for the procedure, even though the surgeon did not perform a colostomy? Virginia Subscriber Answer: No, you should not code the procedure you describe using 44208 (Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy [low pelvic anastomosis] with colostomy). You've identified the problem with using that code -- the surgeon did not form a colostomy, but instead, did a diverting ileostomy. Do this: Code the procedure as 44207 Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy [low pelvic anastomosis]) plus 44187 (Laparoscopy, surgical; ileostomy or jejunostomy, non-tube). Correct Coding Initiative (CCI) edits don't bundle these two codes, which means you don't need modifier 59 (Distinct procedural service) to bill the codes together. Most payers no longer require you to list modifier 51 (Multiple procedures), but you can expect a multiple-procedure discount to be [...]


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