AHA Coding Clinic® for ICD-9 - 2009 Issue 1; Ask the Editor

Reversal of Colostomy with Segmental Resection

The patient presented several months ago with a strangulated inguinal hernia. At that time, the findings upon surgical exploration were active Crohn’s disease with perforation of the sigmoid. He underwent sigmoid resection with creation of colostomy. The Crohn’s disease is now controlled and the patient is admitted for reversal of Hartmann colostomy. The surgeon listed, “Partial colon resection, coloproctostomy (side to side anastomosis) and reversal of Hartmann colostomy,” in the operative summary. In accordance with Coding Clinic Third Quarter 1997, pages 9-10, our hospital has been routinely coding “bowel resection” with colostomy closure. However, it seems that the bowel resection is inherent to the procedure. How should this case be coded? ...

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