Reader Questions:
Distinguish Partial/Total Colectomy
Published on Tue Jan 18, 2011
Question: Does the following note for a laparoscopic procedure describe a partial or total colectomy, and what is the proper code for the procedure? "The mid-sigmoid colon was grasped and then resection was performed utilizing the GIA staple gun and a ligature instrument to transect the mesocolon. Two colotomy incisions were performed on anti-mesocolon border and a staple gun was utilized to perform a functional end-to-end anastomosis."Answer: The procedure you describe involves a partial colectomy, but this portion of the operative note doesn't provide enough information to assign a specific code.Partial vs. total: Total colectomy involves removal of the entire colon from the ileocecal valve to the rectum. The sigmoid colon is only the last part of the colon before the rectum and removal of that alone is not a total colectomy.Because they describe total laparoscopic colectomy, you shouldn't select a code from the range 44210-44212 (Laparoscopy, surgical; colectomy, total, [...]