Wiki Ileostomy Takedown

[jbrown71]

I am stuck. Procedures performed: Diagnostic Lap, Lap lysis, conversion to exp. lap and ileostomy takedown.
Patient had dense adhesions therefore the lap was abandoned. Midline incision was made thru the patients old scar.Opening along the way taking down multiple dense adhensions of omentum. Eventually completely freef and brougth the ileostomy thru the abd wall. Oatomy amputated. I briefly described the op. Patient is post status exp lap from small bowel resection.
44620-44625 can be used? what about 44310 and 44227? Dx I used V55.2/560.81/v64.41. Please help

 

[EricaR]

Based on the brief description sounds like 44620-44625, just going to depend on if/where the anastamosis is. You will not be able to bill LAP codes as this was converted to open. so no to 44227. as far as 44310 did the Dr. perform another Ileostomy?? Sounds like if all that was essentially done is take down of Ileostomy you are only going to get one of the 44620-44625. I agree w/the dx info. Also if the surgeon dictated well enough you may add a 22 to the LOA, if you can support it. (we stick with LOA over an hour gets a 22). Hope thats helpful