# Ileocolectomy with end ieostomy



## vkratzer (Oct 8, 2010)

Pt had right colectomy for polyp then developed signs of peritonitis.  Returned to or.  Pt had anastomotic leak.  Stapler was passed across the ileum proximal to the leak and similar procedure was followed for colon distal to leak.  Given patient's poor nutritional status as well as wound classification it was determined that end ileostomy would be in patients best interest.   The colon was stapled off distally and then surgeon matured the ieostomy and placed appliance.  Not sure how to code.  Do i bill for closure of enterostomy and also bill for ileostomy???

44620
44310

appreciate any help with this.

Vicky k


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## dav4code (Oct 8, 2010)

vkratzer said:


> Pt had right colectomy for polyp then developed signs of peritonitis.  Returned to or.  Pt had anastomotic leak.  Stapler was passed across the ileum proximal to the leak and similar procedure was followed for colon distal to leak.  Given patient's poor nutritional status as well as wound classification it was determined that end ileostomy would be in patients best interest.   The colon was stapled off distally and then surgeon matured the ieostomy and placed appliance.  Not sure how to code.  Do i bill for closure of enterostomy and also bill for ileostomy???
> 
> 44620
> 44310
> ...



Don't you need to determine if the global period for the colectomy is in play? The anastomosis was done at the time of the colectomy by my reading?


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