# Dilation of ileoanal anastomosis



## FLSJarrel (Jul 18, 2012)

Haven't seen this before and I am hoping someone can guide me:
The physician performs a exploratory laparotomy to explore a small bowel obstruction, he identifies significant adhesions & dilated small bowel then the op report states:

Rectal exam was then performed, and a large amount of stool was evacuated out.  It was thought that he might have a stricture at the ileoanal anastomosis.  that area was dilated with a 25, 29, & then a 33 anal sizer.

He continues with: I scrubbed back in & bowel adhesions were taken down, etc.

I have the code for the lysis of adhesions, but for the dilation of ileoanal anastomosis It does not appear that he used endoscopy, but he used an anal sizer, would this possibly be coded with 45910?  As the patient has an ileoanal anastomosis the patients anatomy has changed, and I do not see any codes for dilation without endoscopy.  

Does anyone have a suggestion?
Thanks for any direction you can give.


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## colorectal surgeon (Aug 17, 2012)

I would probably code only the lysis of adhesions. The only other thing I can think of is a pouch endoscopy code but he doesn't state that. There's not a stricture dilation code except for balloon dilation.


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