General Surgery Coding Alert

Question: What codes would you use for lower anterior resection with anal anastomosis and divered ileostomy with mobilization of splenic flexure, which was converted to an open procedure?Louisiana SubscriberAnswer: You'll report the open procedure codes for this case. Take a look at 44145 (Colectomy, partial; with coloproctostomy [low pelvic anastomosis]) for the lower anterior resection (LAR, which is a colectomy) and +44139 (Mobilization [take-down] of splenic flexure performed in conjunction with partial colectomy [list separately in addition to primary procedure]) for the take-down of the splenic flexure.When your surgeon converts a surgical lap procedure to an open procedure, you can only report the open procedure code. You'll use the diagnosis code to tell the payer about the lap-toopen conversion. Use V64.41 (Laparoscopic surgical procedure converted to open procedure) as a secondary diagnosis to document on the claim that the surgeon converted from laparoscopic to open technique. Using V64.41 does not [...]