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tci General Surgery Coding Alert - 2000 Issue 10

Waiting for Colostomy Closure Pathology Results Can Optimize Payment

When a physician closes a colostomy, resection and anastomosis of the bowel may or may not be performed. Resection and anastomosis often accompany a closure. If the surgeon doesnt indicate that the resection was performed, coders should request the pathology report, if one is pending, before billing the procedure, as there is a large (almost five relative value units [RVUs]) difference between a simple colostomy closure and one involving resection and anastomosis. Better yet, the surgeon should describe any resection and anastomosis performed with a colostomy closure during the same operative session by noting in the operative note, for...

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