Hello, can someone please help with the code for this procedure. Thoughts on 45990 ?
Male with history of IBD, proctocolectomy with loop ileostomy presented with prolapsed ileostomy x 4 days. He has been followed at XXXXX Hospital with a colorectal surgeon and is in the planning stages for ostomy reversal. I had a long discussion with the patient and explained that since he has definitive surgery planned, if ostomy appears healthy I would try to reduce it in the operating room rather than resect it.
Operative procedure/Course
Patient taken to the operating room and general anesthesia induced. The ostomy appliance was removed the ileostomy inspected. The mucosa was edematous appearing and beefy red at the end but there were no areas of necrosis or ischemia and the segment was peristalsing. Table sugar was applied to the ostomy in order to draw out the edema, as well as cold compresses. Gentle pressure was applied starting from the distal portion and the prolapsed segment was slowly reduced back into the abdomen. Both limbs of the ostomy were digitally explored and felt patent. An ostomy appliance was reapplied. The patient was awakened from anesthesia. An abdominal binder was placed. He was transferred to the recovery in stable condition.
Male with history of IBD, proctocolectomy with loop ileostomy presented with prolapsed ileostomy x 4 days. He has been followed at XXXXX Hospital with a colorectal surgeon and is in the planning stages for ostomy reversal. I had a long discussion with the patient and explained that since he has definitive surgery planned, if ostomy appears healthy I would try to reduce it in the operating room rather than resect it.
Operative procedure/Course
Patient taken to the operating room and general anesthesia induced. The ostomy appliance was removed the ileostomy inspected. The mucosa was edematous appearing and beefy red at the end but there were no areas of necrosis or ischemia and the segment was peristalsing. Table sugar was applied to the ostomy in order to draw out the edema, as well as cold compresses. Gentle pressure was applied starting from the distal portion and the prolapsed segment was slowly reduced back into the abdomen. Both limbs of the ostomy were digitally explored and felt patent. An ostomy appliance was reapplied. The patient was awakened from anesthesia. An abdominal binder was placed. He was transferred to the recovery in stable condition.