General Surgery Coding Alert

Question: What defines a low-pelvic anastomosis as opposed to a partial colectomy -- is it the coloproctostomy hook-up or the location below the peritoneal reflection that distinguishes the two?Ohio SubscriberAnswer: Partial colectomy describes the surgical removal of a colon section. The surgeon can reconnect the end(s) of the resected bowel in various ways, one of which is a coloproctostomy. Another name for coloproctostomy is "low-pelvic anastomosis," which involves suturing the resected end of the colon to the rectum.In other words, a partial colectomy may include a low-pelvic anastomosis, or may involve a different method/location of attaching the colon following resection. The CPT® codes help you see the different surgical options for reconnecting the colon as part of a partial colectomy:44204 -- Laparoscopy, surgical; colectomy, partial, with anastomosis44206 -- ... colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)44207 -- ... colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)44208 -- ... [...]