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J pouch

Heidi Posted Wed 18th of January, 2017 06:35:08 AM
the procedure is J-pouch excision, proctectomy and end ileostomy what CPT code would I use ? I know i would use 44620 for end ileostomy but I need to know what to use for the j pouch excision
SuperCoder Answered Thu 19th of January, 2017 02:16:11 AM

In this procedure the physician removes an ileoanal reservoir and creates an ileostomy. An ileoanal reservoir is an internal pouch formed of small intestine. This pouch provides a storage place for stool in the absence of the large intestine which is removed in conditions like chronic ulcerative colitis, colon cancer and familial polyposis. The physician makes an abdominal incision upto the site of the ileoanal reservoir. The reservoir is removed at a place where the ileum was previously joined to the anus. The anus is closed. The terminal ileum is brought out through an opening in the abdomen to form a stoma on the abdominal wall. The ileum is sutured to the anal canal via the transanal approach. Interrupted sutures complete the ileostomy construction. The code will be 45136.

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