# End ileostomy



## cynthiabrown (May 22, 2012)

Help!!! Laparotomy with small bowel resection x2   end ileostomy with hartman procedure


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## cmartin (May 22, 2012)

If only small bowel was resected, there should also be one anastomosis - the end ileostomy & Hartmann would only account for the ends of one resection. That would give you a 44120 & a 44125, & you're probably going to need a 59. The Hartmann usually refers to the rectum with a left colectomy & end colostomy of descending or sigmoid colon, but my docs sometimes have a right colectomy w/end ileostomy & "long Hartmann's" in, for instance, the transverse colon. They basically use it to refer to any time they staple the other end shut & tag it for later re-attachment. Unfortunately, the CPT has yet to recognize that fairly-frequent procedure. But if your doc really only resected small intestine, and really did 2 resections, then I think it would be as above.


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## cynthiabrown (May 22, 2012)

thank you . i get so confused about these colectomies...........wish someone would explain it in simple terms, been searching all over for something like that


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