# Perforation repair



## hudsondna (May 5, 2014)

My diagnosis is Sigmoid diverticulitis with evidence of perforation. The physician performed Pericolonic fat patch placed over area of perforation with extensive abdominal wash out with drain placement.
How would I code this?
Thank you for any help that can be given. 

Anita


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## jroxas (May 7, 2014)

Hi
Codes are 44604 (no colostomy) and 44701.  Dx 562.11, Do not code 49905 -bundled
Jerry Roxas, CPC


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## cynthiabrown (May 7, 2014)

44701 IS FOR COLONIC LAVAGE NOT ABDOMINAL WAH OUTThe patient's colon is flushed during a surgical procedure. A Foley catheter is inserted into the cecum through which the irrigation is performed. A noncrushing bowel clamp is placed across the terminal ilium to prevent the lavage fluid from flowing into the small intestine. An intravenous infusion set is connected to the catheter and a clear, corrugated scavenger tube is inserted in the distal bowel and secured in place. A closed irrigation system is created by securing a large bag to the free end of the tube, draped over the patient to the side. The colon is lavaged with warm, isotonic saline solution for 15 to 30 minutes until the flow through the tube is seen to be clear.


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## jroxas (May 7, 2014)

Remember t there was a perforation of the colon and contents to the abdominal cavity


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## jroxas (May 7, 2014)

Pre op colonic lavage is not performed when there is a perforated diverticulitis so lavage is done intra op per my Surgeon


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