# Small bowel resection creation of end jejunostomy and creation of mucous fistula



## R1CPC (Feb 4, 2015)

The small bowel was resected and anastamosed because this patient had multiple peforations the physician decided to bring out the proximal end of jejunostomy and the ileum as a mucous fistula. Help with code please???


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## cynthiabrown (Feb 5, 2015)

look at 44130


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## R1CPC (Feb 5, 2015)

Would this cover the creation of jejunostomy and muscous fistula? I guess I'm trying to find cpt 44144 but for the small bowel. I'm trying to avoid using an unlisted code


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## cynthiabrown (Feb 5, 2015)

it is with or w/o cutaneous enterostomy


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## R1CPC (Feb 5, 2015)

What if he performed one succesful anastamosis on the distal part of the ileum? After that was anatamosed he turned to the jejunum and tried to anastamos but the staples wouldnt hold so that when he created the cutaneous fistula by using the PROXIMAL ileum and end jejunum. Do we code that separately? 44120(distal ileum) and 44130 for proximal ileum & jejunum even if these two parts were not anastamosed?


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## cynthiabrown (Feb 6, 2015)

what about 44120  and 44310-59


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## R1CPC (Feb 6, 2015)

Yeah I thought about that but wouldnt that be the same as coding 44125? or would this be an exception since the first resection was in a separate location from the mucous fistula creation? Would 44120 & 44310 cover the mucous fistula 44310 says jejunostomy or ileostomy would we bill it 44310 44310-59? Thanks for getting back to me i appreciate your help.


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## cynthiabrown (Feb 6, 2015)

i THINK i WOULD GO WITH JUST THE TWO.......AND YES, BECAUSE SEPERATE


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## R1CPC (Feb 6, 2015)

I'm sorry which two did you mean?


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## cynthiabrown (Feb 9, 2015)

44120   44310-59


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## R1CPC (Feb 9, 2015)

Thanks for the help


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