# How to code Gel Port hand access laparoscopic colectomy



## mcarrillo (Nov 12, 2011)

Should an open code or a laparoscopic code be used when a physician does a colectomy using the laparoscopic assisted hand access GelPort system?

He documents-  'the entire ascending colon and terminal ileum were extracorporealized leaving the sleeve of the GelPort device as a wound protector' and 'The terminal ileum and proximal  ascending colon immediately distal to the cecum were cleared of surrounding  fat and mesentery.  The terminal ileum was then approximated in a side to  side fashion to the ascending colon...'  'a side to side functional end to end anastomosis.  The enteric  defect was then closed with an application of TA60 stapling instrument  oriented to maximize luminal aperture and the specimen was then sharply  amputated and immediately moved to a back table where it was opened...'

He is removing the intestines through the gelport opening after viewing the abdomen through the laparoscope, and then desufflating the abdomen and bringing out the intestines of the gelport opening.

Thank you
mcarrillo


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## TonyaMichelle (Nov 12, 2011)

The Gel Port system is used to permit abdominal access and frequent instrument exchange during surgery without compromising the peritoneum.

Laparoscopic surgery is a keyhole surgery.
Open surgery requires major, long incisions.
As per your doctor report, there were no major, long incisions made.
Anastamosis was done and part of  the intestine was excised.

So, I would use code 44204 (Laparoscopy, surgical; enterectomy, resection of small intestine, colectomy, partial, with anastomosis).

Hope this helps.


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## mcarrillo (Nov 14, 2011)

TonyaMichelle

Thank you. This does help.


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