tci General Surgery Coding Alert - 2010 Issue 9

Reader Questions: Capture Return to OR Charges With 78

Question:  On August 4 a patient had a total colectomy (44150). He developed an anastomotic leak with fistula and intra-abdominal abscess and had to be taken back to surgery on August 18 for exploratory laparotomy with drainage of abscess, end ileostomy, and mucus fistula creation. The surgeon used a loop of small bowel and brought the proximal end up as a matured colostomy and made a mucus fistual with the other end. What code should I use for this procedure?Oregon SubscriberAnswer: You should report either 49020 (Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; open)...

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