# Small bowel resection w/double barrel ileostomy



## cauer (Jun 4, 2010)

I'm not sure if I should use both codes 44125 & 44310/59.  CCI edits says I can modify with a 59, but would like second opinion based on the following dictated note:
"The level of obstruction was in the terminal ileum.  This was resected and the 2 limbs of the terminal ileum were pulled out as a double barrel with ileostomy and mucous fistula.  The previous anastomotic line was explored. However the anastomotic line was completely intact, and there was no relation to the abscess.  Because of that, a diverting loop ileostomy was done to protect the anastomosis in the form of a double barrel, especially the level of the obstruction in the small bowel at the same site, and after resection was pulled out in 2 limbs."

Patient's previous surgery was 2 weeks prior to this & was coded as 44160, & 49905.

Your help would be greatly appreciated!   
Cathy


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