![]() ![]() She was diagnosed with acute appendicitis. What CPT® and ICD-10-CM codes are reported for the surgeon?ĭ) 42215-53, Q35.9, R56.9 B A 28 year-old female had symptoms of RLQ abdominal pain, fever and vomiting. The surgeon quickly terminates the surgery in order to stabilize the patient. Shortly after general anesthesia is administered, the patient begins to seize. What is the correct coding for the subsequent services on this date of service? The same surgeon took her back to the OR as the one who performed the original operation.ĭ) 49402-78 D An 11 year-old patient is seen in the OR for a secondary palatoplasty for complete unilateral cleft palate. The area had become inflamed and was demonstrating early signs of peritonitis. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. Five hours later, she has an enormous amount of pain, abdominal swelling and a spike in her temperature. ![]() ![]() What CPT® and ICD-10-CM codes are reported?ĭ) 45320, K62.1 C Margaret has a cholecystoenterostomy with a Roux-en-Y. During the procedure, two polyps are found in the rectum. His physician decides to perform a rigid proctosigmoidoscopy. What is/are the correct CPT® code(s) to report?ĭ) 45378, 45380-51 C What ICD-10-CM code(s) is reported for ulcerative colitis with rectal bleeding?ĭ) K51.90 C What is the CPT® code for removal of a foreign body from the esophagus via the thoracic area?ĭ) 43045 D Where is the vermilion border located?ĭ) In the esophagus B What ICD-10-CM code is reported for internal hemorrhoids?ĭ) K64.0 C A 56 year-old patient complains of occasional rectal bleeding. When performing the service, the physician notes suspicious looking polyps and removes three using a snare technique to send to pathology for further testing. D A patient is seen in the gastroenterologist's clinic for a diagnostic colonoscopy. There is a learning curve involved in such procedure and it can easily be overcome in high volume centers.Ĭolorectalanastomosis minimally-invasivesurgery oncologicalandfunctionaloutcomes restorativecolorectalresection splenicflexuremobilization.In ICD-10-CM, how is Crohn's disease of the small intestine with intestinal obstruction reported?Ī) Crohn's disease of the small intestine is reported first with intestinal obstruction reported as a secondary diagnosis.ī) Intestinal obstruction is reported first with Crohn's disease of the small intestine is reported as a secondary.Ĭ) One combination code is reported to indicate Crohn's disease of the small intestine with intestinal obstruction.ĭ) Crohn's disease of the small intestine is reported as regional enteritis of the small intestines. Conclusions: In our perspective, the routine mobilization of the splenic flexure as a first step of the colorectal restorative resections associate many advantages and these strategies should be largely used. The mean follow-up for these patients is 7 months (range, 4-12 months). No early cancer recurrence, deaths or major complication were encountered. No intraoperative incidents were associated with the SFM. The robotic approach has been used in 40% (16 patients). There were 30 patients with rectal cancer, 10 with sigmoidal tumors, five with sigmoidal resection for diverticulitis and Hartmann reversal was indicated in two. Results: Between January and December 2018, 47 patients had SPM as a first step of the performed colorectal procedure in our institution. However, the combination of different maneuvers for an easier, safer approach decreases the morbidity and is saving surgical time. There are four routes for SFM: two from medial to lateral, one starting from the splenic vein the other one from the promontory, a superior to inferior approach and a lateral to medial approach. Method: A detailed description of the laparoscopic surgical technique for SFM is performed. The aim of this paper is to describe the technique of laparoscopic splenic flexure mobilization and to discuss the advantages of using it as the first surgical step in colorectal rectal resection analyzing our last 12 months experience (2018). Looking for improved expertise and better outcomes, in 2016, we have decided to routinely perform SFM as a first step of all the laparoscopic or robotic sigmoid and rectal resections. However, the surgical procedures are technically complex thereby overcoming the learning curve may not be an easy process. Background: Mobilization of the colonic splenic flexure (SFM) is an essential surgical step of the restorative rectal resections. ![]()
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