AHA Coding Clinic® for ICD-9 - 2014 Issue 1; Ask the Editor
Malone Antegrade Continence Enema (MACE) Procedure
A four-year-old boy presents to our facility due to imperforate anus and intractable constipation. Laparoscopic-assisted Malone Antegrade Continence Enema (MACE) procedure was performed with V-Q-Y skin flap. During the procedure, the appendix was mobilized up to the umbilicus and delivered. The tip of the appendix was amputated and the appendix was then cannulated with the mentor catheter. The surgeon then made a subserosal tract in the tenia of the cecum with cautery and buried the appendix in this tract. Once this was completed, the appendix and cecum was returned to the abdomen and the appendiceal tip was delivered through the right lower quadrant incision. The incision was modified to create a V-Q-Y skin flap. The end of the appendix was spatulated and the skin flap anastomosed to the spatuled end to splay it open. The remainder of the flap was then closed and the Mentor catheter was secured to the skin. Coding Clinic, Third Quarter 2001, page 16, advises coders to assign code 47.99 for the MACE procedure. However, the MACE, Malone procedure and appendicostomy are all synonymous. What is the appropriate code assignment for this surgery? ...
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Article Overview
This premium article explains a pediatric colorectal surgery case involving a Malone antegrade continence enema approach and references official coding guidance. It is useful for coders, CDI professionals, and surgical coding staff who work with gastrointestinal, pediatric surgery, and procedure coding topics and want to understand how the case is framed within coding references.
Why This Topic Matters
The article helps readers assess whether this type of operative report and related coding reference is relevant to their work in pediatric surgery and procedure coding.
Article Sections
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Clinical Case and Operative Description
A pediatric operative scenario is presented with a detailed description of the surgical approach and reconstruction steps involved in the case.
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Coding Clinic Guidance
The article notes a coding reference tied to the procedure and points readers to official guidance for code assignment.
What You Will Learn
- The clinical setting and general purpose of the procedure discussed in the article.
- How the article connects an operative report to a formal coding reference.
- Which coding sources are relevant to this type of pediatric surgical case.
- How the article frames the documentation for coding review.
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation improvement specialists
- Pediatric surgery coding staff
- Revenue cycle professionals
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