Merlin0728
Networker
I'm looking for an opinion on the following surgery:
A small upper midline incision was made subcutaneous tissues were divided down the level of fascia Bovie electrocautery. Fascia was opened in the midline and the peritoneum was incised sharply. The transverse colon was identified and ligament of Treitz was identified protruding through the mesial colon. The ligament of Treitz to a distance of 25-30 cm distally the jejunum was followed. A pursestring suture of 3-0 silk was placed the jejunostomy tube was introduced into the perineal cavity through the anterior abdominal wall through a separate stab incision. An enterotomy was made and the jejunostomy tube was followed up to the second flange and secured. A 30 Witzel tunnel jejunostomy was then created. The cuff was brought to the anterior abdominal wall. The jejunal loop was secured to the peritoneal lining using 3 anchoring sutures in a triangular fashion. The catheter easily flushed to both pressure as well as gravity. Once I was satisfied with the patency in the nice contour the catheter the catheter was secured to the anterior abdominal wall using 2-0 nylon. The area was irrigated hemostasis was excellent. The fascial defect was closed using #1 Vicryl in a figure-of-eight fashion subcutaneous tissues were copiously irrigated the skin was closed using 4-0 Monocryl in a subcuticular fashion.
I came up with CPT code 44300 but would like additional opinions on this.
Thank you for any input you may have!
A small upper midline incision was made subcutaneous tissues were divided down the level of fascia Bovie electrocautery. Fascia was opened in the midline and the peritoneum was incised sharply. The transverse colon was identified and ligament of Treitz was identified protruding through the mesial colon. The ligament of Treitz to a distance of 25-30 cm distally the jejunum was followed. A pursestring suture of 3-0 silk was placed the jejunostomy tube was introduced into the perineal cavity through the anterior abdominal wall through a separate stab incision. An enterotomy was made and the jejunostomy tube was followed up to the second flange and secured. A 30 Witzel tunnel jejunostomy was then created. The cuff was brought to the anterior abdominal wall. The jejunal loop was secured to the peritoneal lining using 3 anchoring sutures in a triangular fashion. The catheter easily flushed to both pressure as well as gravity. Once I was satisfied with the patency in the nice contour the catheter the catheter was secured to the anterior abdominal wall using 2-0 nylon. The area was irrigated hemostasis was excellent. The fascial defect was closed using #1 Vicryl in a figure-of-eight fashion subcutaneous tissues were copiously irrigated the skin was closed using 4-0 Monocryl in a subcuticular fashion.
I came up with CPT code 44300 but would like additional opinions on this.
Thank you for any input you may have!