# Removal polyp inside ileostomy no scope



## acbarnes (Dec 5, 2008)

My physician excised five polyps and ablated 2 just inside an ileostomy. He excised them by going underneath the polyps in the submucosl plane, using lidocaine with epinephrine as anesthestic. He did not use a scope. How would you code this?

 My guess would be either 44110-52 (five were excised in one excision, same spot). I looked at teh 4436? codes but could not really make anything fit. Has anybody else coded this?

Thanks, 
Anna Barnes, CPC, CGSCS


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## elenax (Dec 8, 2008)

I have not come accross a polyp removal without a 'scope' but I also came out with the *44110 *which is described below; If you report can support this
description I would go with the 44110.  Your last resource would be the *unlisted* code *44799.*

"The physician removes one or more lesions in the small or large intestine through an incision in the colon (colotomy) or small intestine (enterotomy) without bowel resection. The physician makes an *abdominal incision*. Next, the segment of small intestine or colon containing the lesions is mobilized. An incision is made in the *small intestine* or colon and the lesions are removed. The enterotomy or colotomy is closed with staples or sutures. The abdominal incision is closed."

Hope this helps!!


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## NARCHER (Dec 10, 2008)

How Did He Know There Were Polyps There W/o A Scope And Their Exact Location???


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## acbarnes (Mar 12, 2009)

He visualized the polyps on the ileostomy where the stoma is brought out to the outside of the abdomen. There is no abdominal incision or scope. A stoma is intestine brought out through the abdomen to form either an ilesotomy (small bowel) or colostomy (large bowel). 

I hope this makes sense.

Anna Barnes, CPC, CGSCS


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## jdrueppel (Mar 12, 2009)

What about 44312  - simple revision ileostomy?  Otherwise I'd stick with the unlisted 44799.

Julie, CPC


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