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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Article Overview
This premium article reviews a colostomy reversal scenario involving prior colon surgery, Crohn’s disease, and a surgeon’s operative summary that includes additional resection language. It is aimed at coding professionals who need to understand how the case aligns with official inpatient coding guidance and how to distinguish the main procedure framework from related operative terminology. The article also references prior Coding Clinic guidance and the implications for assigning the case correctly.
Why This Topic Matters
Colostomy reversal cases can be coded differently depending on the operative report and the coding guidance in effect. Understanding how this article frames the scenario helps coders evaluate whether additional procedure terminology changes the coding approach.
What You Will Learn
- How a Hartmann colostomy reversal case is discussed in relation to inpatient coding guidance.
- How prior Coding Clinic references are incorporated into the coding discussion.
- How operative-summary terminology can affect review of the procedure context.
- The general coding considerations involved in this type of colorectal surgery case.
Who Should Read This
- Inpatient coders
- Coding auditors
- Clinical documentation integrity specialists
- Health information management professionals
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