# cpt help please!



## tategc (May 2, 2011)

Patient had a lap-assisted completion proctectomy with ileoanal J-pouch; ileostomy takedown (done at the time of a previous subtotal colectomy); and then a loop ileostomy was created "which was brought up through our previous ileostomy site".  I like 44211, but wonder where they utilitized the same ileostomy site, can it be billed?  And if so, can the ileostomy takedown be billed as well?


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## surgonc87 (May 2, 2011)

please post op note


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## colorectal surgeon (May 2, 2011)

45113 is the closest open code. Any other suggestions besides coding this with a 22 modifier for the laparoscopic approach? Other option is the 999 code for unlisted procedure.


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