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Hand Assisted Hemicolectomy with ileal transverse colostomy

Eva Posted Mon 02nd of March, 2015 20:05:26 PM

How would you code the above?

SuperCoder Answered Tue 03rd of March, 2015 02:49:26 AM

Thank you for the query.
Hand assisted Hemi colectomy is a laparoscopic procedure and hence the correct code to be billed should be 44205.

Hope this helps!

Eva Posted Tue 03rd of March, 2015 17:21:18 PM

What if the report did not mention a colostomy he only mentions anastamosing the ileal to the transverse that possble would the cpt change then to 44204? for example "distal ileum was divided I approximated the antimesenteric border of the distal ileum with the antimesenteric border of the proximal transverse colon with stay sutures enterotomies were achived anastamosis were patent"

SuperCoder Answered Wed 04th of March, 2015 02:54:13 AM

Hi Eva,
Thank you for the query.
CPT code 44204 cannot be reported in this case because this code can be used only for partial colon removal and then anastomosis. In our case, along with partial colectomy, distal ileum was also removed. So CPT code 44205 is the correct code.

Eva Posted Wed 04th of March, 2015 15:58:00 PM

I think my concern is the colostomy, the physician did not mention creating a stoma and this code clearly says with ileostomy. Where does it say ilestomy is equal to an anastamosis?

SuperCoder Answered Thu 05th of March, 2015 02:33:08 AM

As per CPT codes available with us, CPT code 44205 is the best possible code that we can use. Its descriptor clearly indicates that this code should be used for laparoscopic partial removal of colon and distal ileum followed by ileal transverse colostomy.
The descriptor of CPT code 44204 indicates that excision of the diseased part of the colon is performed. The remaining ends of the colon are brought together and sutured or stapled.

I hope this information will be helpful.

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