# cpt code help abdominal silo



## boyced@email.chop.edu (Jun 20, 2014)

Please help.

I have a patient who has a diagnosis of Inestinal perforation and abdominal compartment syndrome.
The patient went to the OR had a closure of the duodenal ulcer, placement of a graham patch and placement of a abdominal silo.

The patient has MA, which means I can't submit unlisted codes.
The only silo codes I come up with are the codes for gastroschisis ( 49605) and i do not believe that applies in this case.

Any help would be greatly appericated.. I have attached the procedure op note:


At this point, I scrubbed in.  The patient had stabilized after the abdomen was opened.  We then proceeded to explore the abdomen and ran the entire bowel.  In doing so, we saw a small anterior perforation of the duodenum from which tube feeds and bile were leaking.  The remainder of the bowel appeared healthy, although it was stained yellow from the leaking of the feeds.  We then placed three 4-0 PDS stitches to close the perforated duodenal ulcer and then planned to place a Graham patch of omentum on top of the closed ulcer.  In order to do this, we freed up the omentum from the transverse colon.  This omentum was then placed on top of the ulcer repair and secured using the ends of the 3 stitches that were placed to repair the ulcer.  At this point, the patient was more stable; however, still required an FiO2 of 100% and 10 of dopamine.  Therefore, given the stress that the baby was under, we felt that it was prudent not to close the abdomen.  We asked for a #10 silo, in which we placed the intestine and placed it underneath the fascia.  This completed the procedure.  The silo was secured with Xeroform and a Kling wrap, and was secured to the warmer over the bed.  The patient remained intubated and stable at the completion of the procedure.


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