# Closure colostomy w/resection & LAR?



## acbarnes (May 18, 2009)

I am arguing with my boss over a particular case. He performed a colostomy closure and resected a large segment of rectosigmoid before performing teh anastomosis. He took down the stoma and resected a small piece of bowel from it and then went down to the rectum/sigmoid and resected a large piece of bowel and then hooked the two ends together. I say he can only bill 44626, but he wants to bill 44626 and 44145 (low anterior resection), but there is only one anastomosis and one dignosis (V55.3 colostomy status). CCI passes 44145 and 44626 but 44626 includes resection with colorectal anastomosis. He billed and got paid for a 44145 and 44626 before but I bet it would not survive an audit. Any feedback would be great....

Anna Barnes, CPC, CGSCS


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## cmartin (May 21, 2009)

I'd say you are correct - one anastomosis and one dx = one procedure, 44626.
C.Martin
CPC,CGSC


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## acbarnes (May 21, 2009)

Thanks! 

Anna


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