# Release of small bowel obstruction



## MCook (Mar 3, 2010)

I can not find a code for this procedure.  It was performed following an open appendectomy.  Here is the op note in part...

The remaining abdomen is then explored, The smaIl intestine is run from the ileocecal valve to the ligament of Treitz taking down multiple dense exudative adhesions, subsequently identifying the area of potential concern for the bowel obstruction in a relative transition zone in the distal ileum associated again with the inflammatory exudate earlier described, The small bowel is run to the ligament of Treltz. Again, the mid portion of the small bowel is dilated
up to probably 5-cm, The air and fluid in the small bowel is milked back to the stomach where a nasogastrc tube has been placed and thick secretions are evacuated. This allows for the small intestine to be retunred to the abdominal cavity. TIle omentum is laid back over the smaIl intestine, The abdomen is irrigated with 5 full liters of warm normal saline until the fluid is noted to be clear.

Thanks in advance!
Michelle, CPC


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## deborahcook4040 (Mar 4, 2010)

this doesn't seem seperately billable to me. It sounds as if all he did was explore the small bowel, and that's bundled with the appendectomy.


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## MCook (Mar 8, 2010)

Thanks for the feedback!  I appreciate it!


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