# Low anterior resection



## JDM1228

I am new to surgical coding and could use a second opinion on the following procedures performed together:
1. Low anterior resection, rectosigmoid, with primary anastomosis with EEA stapler. 
2. Takedown, splenic flexure

I came up with CPT 45111. I am assuming the anastomosis and takedown can not be coded separately & are included in the resection.

Thanks


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## heathermc

we use 44145 if it was open, or 44207 if done laparoscopically.  and yes you can use the mobilization codes 44139 or 44213 with no modifier since these are add on codes.
Heather
CPC, CPC-GENSG


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## JDM1228

Thanks for your reply. 
I guess I'm just wondering if a resection of the rectosigmoid is considered a colectomy or a proctectomy? There isn't a code that is like the endoscopy code (proctosigmoidoscopy) that combines both areas. 
Not sure if that makes sense. 

THanks


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## mmelcam

It is a colectomy. The "lower anterior resection" means they resect a part of the distal colon or rectum and the anastomosis is created between the colon and the rectum.


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## JDM1228

The reason I questioned it is because our Encoder is coming up with a proctectomy code, not the colectomy code.


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## cmartin

We've also always used 44145/44207 & 44213/44139 for L.A.Resects - it's the rectosigmoid colon that's removed, generally.


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