com107
Contributor
One of my doctors did an open gastrostomy tube placement, jejunostomy tube placement and jejunojejunostomy with mega loop placement and a dilation of gastrojejunostomy.
Any help coding this would be really appreciated.
The patient was placed on the table in the supine position. The abdomen was prepped and draped, a vertical supra-umbilical incision was made. The dissection was carried down to the fascia, which was opened sharply. The abdominal cavity was entered. There were minimal adhesions which were broken down bluntly. First I proceeded with the gastrostomy. A double purse string suture was placed in the anterior stomach wall; the stomach was entered with Bovie electrocautery. A large foley catheter was placed through the gastrostomy in the piloroplasty and performed several balloon dilations. A balloon gastrostomy tube was brought inside the abdomen through a left upper quadrant incision. The catheter was placed into the stomach and secured with double purse string sutures. The balloon was then inflated. The gastrostomy site was secured to the anterior abdominal wall with 3-0 PDS suture. After that, attention was directed toward the jejunum. A Witzel jejunostomy was created 30 cm below the ligament of Treitz and brought to the left side of the abdomen through a stab incision. Jejunojejunostomy was done with a linear stapler just below the gastrojejunostomy to defer bile reflux into the stomach.
I'm totally confused...
Any help coding this would be really appreciated.
The patient was placed on the table in the supine position. The abdomen was prepped and draped, a vertical supra-umbilical incision was made. The dissection was carried down to the fascia, which was opened sharply. The abdominal cavity was entered. There were minimal adhesions which were broken down bluntly. First I proceeded with the gastrostomy. A double purse string suture was placed in the anterior stomach wall; the stomach was entered with Bovie electrocautery. A large foley catheter was placed through the gastrostomy in the piloroplasty and performed several balloon dilations. A balloon gastrostomy tube was brought inside the abdomen through a left upper quadrant incision. The catheter was placed into the stomach and secured with double purse string sutures. The balloon was then inflated. The gastrostomy site was secured to the anterior abdominal wall with 3-0 PDS suture. After that, attention was directed toward the jejunum. A Witzel jejunostomy was created 30 cm below the ligament of Treitz and brought to the left side of the abdomen through a stab incision. Jejunojejunostomy was done with a linear stapler just below the gastrojejunostomy to defer bile reflux into the stomach.
I'm totally confused...
