tci General Surgery Coding Alert - 2010 Issue 9

Reader Questions: Lap-to-Open LAR Warrants an Open Code

Question: What codes would you use for lower anterior resection with anal anastomosis and divered ileostomy with mobilization of splenic flexure, which was converted to an open procedure?Louisiana SubscriberAnswer: You'll report the open procedure codes for this case. Take a look at 44145 (Colectomy, partial; with coloproctostomy [low pelvic anastomosis]) for the lower anterior resection (LAR, which is a colectomy) and +44139 (Mobilization [take-down] of splenic flexure performed in conjunction with partial colectomy [list separately in addition to primary procedure]) for the take-down of the splenic flexure.When your surgeon converts a surgical lap procedure to an open...

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