# Resection of recent colorectal anastomosis with re-anastomosis ????



## mgord (Nov 7, 2013)

Patient had a Lap Sigmoid Colectomy. Three days later he was taken back to the OR for persistent anastomotic bleed and had the following:

Reopening of recent laparotomy
Resection of distal colorectal anastomosis
Recreation of colorectal anastomosis
Flexible sigmoidoscopy
Takedown of splenic flexure

I cant repost the op note (which I know would be helpful) but I'll retype if someone could help. 
I read somewhere that you dont code the 49002 for reopening of recent laparotomy when another procedure is performed that its only for a "re-look" (which now that I think of it, doesnt make sense being that the first procedure was Laparoscopic). 
Any help at all would be greatly appreciated!
Thanks.


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## syllingk (Nov 8, 2013)

You don't note if this one is open or lap but it sounds like they resected some more of the colon and put it back together which is basically what they did the first time only with more intestine. It would be 44140-78(no new global)or the lap version 44204-78,


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## syllingk (Nov 8, 2013)

forgot to add the 44139 or 44213 but you would think that would have been done at the first procedure.


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