AHA Coding Clinic® for HCPCS - 2025 Issue 2; Ask the Editor

Laparoscopic revision of Roux-en-Y

A patient with dumping syndrome presented for a small bowel transection and enteroenterostomy. The patient was taken into the operating room and placed under general anesthesia. Four trocars were inserted into the abdominal cavity, and the small bowel was measured. The patient had a 100 cm Roux limb and a 50 cm biliopancreatic limb. The surgeon counted back 250 cm from the ileocecal valve and performed a side-to-side enteroenterostomy with the Roux limb, approximately 5 cm from the previous jejunojejunostomy, using a GIA stapler. The surgeon then undermined the tissue between the anastomosis and the old jejunojejunostomy and transected the Roux limb to create an end-to-side anastomosis. The resultant mesenteric defect was closed. The final limb lengths were 356 cm total alimentary limb, 95 cm Roux limb, and 650 cm biliopancreatic limb. A drain was placed in the abdominal cavity, and the skin incisions were closed.How is the laparoscopic revision of a Roux-en-Y as described above coded? ...

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