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E. maria Posted 7 Year(s) ago

I need help with the CPT code for this procedure I'm thinking 43820?. Patient with recurrent gastric outlet obstructions. The op note is as follows:

Following satisfactory general endotracheak anesthesia, the patient was prepped and draped in a sterile manner. A 0.25% Marcaine with epinephrine was infiltrated. The previous surgical scar was excised ub the upper abdome. Then the incision was extended into the abdominal cavity. Surprisingly,minimal adhesions were present. The Roux-en-Y gastrojejunostomy was able to be brought up and inferiorly into the wound somewhat. There was marked thickening and stricture of the proximal portion if the Roux-en-Y as it connected with the greater curvature of the stomack. the anastomosis was opened and the clear distinction was seen between the atrophic scarred jejunum and the normal gastric mucosa and cautery was used to cut through the margin of the gastrojejunal anastomosis, and the jejunal attachment was completely excised. Then,the stomach was aspirated and the mesentery of this 5 cm portion of thickened narrowed proximal jejunum was divided over clamps and tied with 0 Vicryl. Then the jejunal Roux-en-Y was divided at the margin between the normal and the strictured area and the specimen was removed. Then a single layer, end-to-en anastomosis was performed between the stomach and the remaining portion of the Roux-en-Y which was probably 20to 25 cm in lenght. This anastomosis was done with 3-0 Vicryl in a single layer. The base of the Roux-en-Y was carefully inspected to make sure there was not a stricture either from the biliary aspect or at the Roux-en-Y outlet aspect and there did not appear to be any blockagein this area. Antibiotic irrigation was performed and then additional Marcaine was placed. The midline fascia was closed with double-stranded 0 PDS. The skin was closed with 4-0 Vicryl.

SuperCoder Posted 7 Year(s) ago


E. maria Posted 7 Year(s) ago

Thank you so much. I appreciate your time.

Posted by E. maria, 7 Year(s). There are 3 posts. The latest reply is from E. maria.

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