Wiki Help with surgery coding

[willette]

Any feedback would be great!
I came up with 44145.22 (Fistula was connected to sigmoid colon removed.) 49020 38500

Low anterior resection of the rectum with resection of sigmoid colon along with the colovaginal fistula, drainage of associated pelvic abscess, 2 1/2 hour lysis of adhesions, biopsy of retroperitoneal lymph node, repair of peristomal hernia with biological mesh.

Thank you so much

 

[Lujanwj]

Assuming the sigmoid was anastomosed to the rectum 44145-22(for 2 hr lysing), if abscess is separate and distinct (not all associated with the fistula) 49020-59, assuming dr didn't enter through hernia 49560-59, assuming dr repaired the vagina as the fistula had to of created a defect 57200, Bio mesh could be considered a prothesis so 49568.

44145-22
49020-59
49560-59
57200
49568
Biopsy included as incidental to