# Status Post Gunshot Wound to Right Flank



## tabbsmith (Nov 10, 2011)

I need help with coding:
Gerota's fascia was opened and the kidney was mobilized out of it.  The renal artery and vein were encountered and were controlled with clamps and ties as suture ligatures.  The upper pole had been divided, partly by injury, partly by dissection and it was also away from the fascia.
During the course of dissection, it appeared that there was a tear made in the inferior vena cava.  This was controlled with a running 4-0 Prolene suture.  Once all the vasular structures were divied, the kidney was completely removed.  The bed of kidney fossa was relatively dry and additional hemostatsis was achieved with electrocautery and sutures.  
We then repaired the dudodenum in 2 layers with 3-0 Vicryl and 3-0 silk Lembert sutures.  Ther serosal tears in the colon repaired with 3-0 silk sutures.  The abdomen was copiously irrigated with sterile saline.  The small bowel was inspected.  There was an intussusception in the mid small bowel which was manually reduced.  There were no injuries noted to the small bowel or the remainder of the colon.

Codes that I have are:
50240  --  Nephrectomy
44603  --  Duodenal Injury
44604  --  Serosal Tears 
44050  --  Intussusception (this code is only for Lap)???? needs for Open


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## caromissunc1 (Nov 16, 2011)

You are correct.  Code 44050 is indeed a reduction for intussuseption performed open via laparotomy.


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