AAPC CPC Chapter 11
A
A patient with hypertension is scheduled for same day surgery for removal of her gallbladder due to chronic gallstones. She is examined preoperatively by her cardiologist to be cleared for surgery.
What ICD-10-CM codes are reported by the cardiologist?
A) Z01.810, K80.20, I10
B) I10, Z01.818, K80.20
C) K80.20, I10, Z01.810
D) K80.21, Z01.89, I10
D
A patient is admitted for a simple primary examination of the gastrointestinal system to rule out GI cancer. An Esophagogastroduodenoscopy (EGD) is performed, which includes examination of the esophagus, stomach and portions of the small intestine. During the examination, a stricture of the esophagus is identified and subsequently dilated via balloon dilation (20 mm). What CPT® and ICD-10-CM codes are reported?
A) 43235, K22.2
B) 43235, C15.9
C) 43248, Q39.3
D) 43249, K22.2
D
A screening colonoscopy is performed on a 50 year-old patient with a family history of colon cancer. Multiple polyps were found during the procedure. Two polyps in the transverse colon were removed with hot forceps cautery. Three polyps in the ascending colon were removed via snare. Portions of all polyp tissues were to be sent to pathology. What are the correct CPT® and ICD-10-CM codes for this patient encounter?
A) 48584 x2, 45385 x3, K63.5
B) 45384, 45385-59, K63.5, Z12.11, Z80.0
C) 45384 x2, 45385 x3, Z80.0, K63.5, Z12.11
D) 45384, 45385-59, Z12.11, D12.3, D12.2, Z80.0
B
A 33 year-old male patient presents to the endoscopy suite to determine if he has an ulcer. The physician performs a diagnostic scope through the esophagus, stomach and into the duodenum and jejunum. During the scope the patient has a severe drop in blood pressure and the physician discontinues the procedure, but not before observing and diagnosing a bleeding ulcer on the stomach lining as well a perforated ulcer in the jejunum. A repeat examination is planned.
What CPT® and ICD-10-CM codes are reported?
A) 43235-52, K25.4, K28.5
B) 43235-53, K25.4, K28.5
C) 43200-52, K25.5, K28.5
D) 43235-53, K25.4, K28.1
A
A patient presents for esophageal dilation. The physician begins dilation by using a bougie. This attempt was unsuccessful. The physician then dilates the esophagus transendoscopically using a balloon (25mm). What CPT® code(s) is/are reported?
A) 43220
B) 43450-53, 43220
C) 43450, 43220
D) 43220, 43450-52
D
How do you report a screening colonoscopy performed on a 65 year-old Medicare patient with a family history of colon cancer? The physician was able to pass the scope to the cecum. What CPT® and ICD-10-CM codes are reported?
A) 45330, Z13.818, Z80.0
B) 45378, Z12.11, Z85.038
C) G0104, Z13.818, Z85.038
D) G0105, Z12.11, Z80.0
A
A patient presents with a 2 cm benign lip lesion. The provider decides to remove the lesion along with a portion of the lip by performing a wedge excision. Single-layer suture repair is performed. What CPT® code(s) is/are reported for this service?
A) 40510
B) 11442, 12011-51
C) 40510, 12011-51
D) 11442, 40510
A
What is the correct ICD-10-CM code for a patient with IBS?
A) K58.9
B) K59.2
C) K58.0
D) K59.8
A
What is the correct CPT® coding for a partial distal gastrectomy with Roux-en-Y reconstruction with vagotomy?
A) 43633, 43635
B) 43634, 43635
C) 43621, 43635
D) 43633, 43640-51
D
What CPT® and ICD-10-CM codes are reported for diagnosis of a recurrent unilateral reducible femoral hernia repair?
A) 49550, K41.91
B) 49555, K41.21
C) 49505, K41.31
D) 49555, K41.91
D
In ICD-10-CM, how is Crohn’s disease of the small intestine with intestinal obstruction reported?
A) Crohn’s disease of the small intestine is reported first with intestinal obstruction reported as a secondary diagnosis.
B) Intestinal obstruction is reported first with Crohn’s disease of the small intestine is reported as a secondary.
C) One combination code is reported to indicate Crohn’s disease of the small intestine with intestinal obstruction.
D) Crohn’s disease of the small intestine is reported as regional enteritis of the small intestines.
C
A patient is seen in the gastroenterologist’s clinic for a diagnostic colonoscopy. When performing the service, the physician notes suspicious looking polyps and removes three using a snare technique to send to pathology for further testing. What is/are the correct CPT® code(s) to report?
A) 45378, 45385-51
B) 45380
C) 45385
D) 45378, 45380-51
C
What ICD-10-CM code(s) is reported for ulcerative colitis with rectal bleeding?
A) K51.511
B) K52.9, K62.5
C) K51.911
D) K51.90
D
What is the CPT® code for removal of a foreign body from the esophagus via the thoracic area?
A) 43215
B) 43020
C) 43500
D) 43045
B
Where is the vermilion border located?
A) Underneath the tongue
B) Upper and lower lips
C) Stomach lining
D) In the esophagus
C
What ICD-10-CM code is reported for internal hemorrhoids?
A) K64.4
B) K64.9
C) K64.8
D) K64.0
C
A 56 year-old patient complains of occasional rectal bleeding. His physician decides to perform a rigid proctosigmoidoscopy. During the procedure, two polyps are found in the rectum. The polyps are removed by a snare. What CPT® and ICD-10-CM codes are reported?
A) 45309, 45309, K63.5
B) 45385, K63.5
C) 45315, K62.1
D) 45320, K62.1
D
Margaret has a cholecystoenterostomy with a Roux-en-Y. Five hours later, she has an enormous amount of pain, abdominal swelling and a spike in her temperature. She is returned to the OR for an exploratory laparotomy and subsequent removal of a sponge that remained behind from surgery earlier that day. The area had become inflamed and was demonstrating early signs of peritonitis. 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.
What CPT® code is reported?
A) 49000-58
B) 49000-77
C) 49402-77
D) 49402-78
B
An 11 year-old patient is seen in the OR for a secondary palatoplasty for complete unilateral cleft palate. Shortly after general anesthesia is administered, the patient begins to seize. The surgeon quickly terminates the surgery in order to stabilize the patient. What CPT® and ICD-10-CM codes are reported for the surgeon?
A) 42220-52, Q35.7, R56.9
B) 42220-53, Q35.9, R56.9
C) 42215-76, Q35.7, R56.9
D) 42215-53, Q35.9, R56.9
C
A 28 year-old female had symptoms of RLQ abdominal pain, fever and vomiting. She was diagnosed with acute appendicitis. The surgeon makes an abdominal incision to remove the appendix. The appendix was not ruptured. The incision is closed. What are the correct CPT® and ICD-10-CM codes for this encounter?
A) 44950, R10.31, R50.9, R11.10, K35.80
B) 44970, K35.80
C) 44950, K35.80
D) 44970, K37
C
A 20 year-old patient presented to the hospital for a sigmoidoscopy due to a history of bloody stools for three weeks’ duration. The patient was prepped for the sigmoidoscopy and the sigmoidoscope was passed without difficulty to about 40 cm. The entire mucosal lining was erythematosus. There was no friability of the overlying mucosa and no bleeding noted. No pseudo polyps were identified. Biopsies were taken at about 30 cm; these were thought to be representative of the mucosa in general. The scope was retracted; no other abnormalities were seen. What CPT® and ICD-10-CM codes are reported?
A) 45330, 45331, K62.5
B) 45333, Z12.11, K62.5
C) 45331, K92.1
D) 45305, K92.1
A
A 45 year-old patient with liver cancer is scheduled for a liver transplant. The patient’s brother is a perfect match and will be donating a portion of his liver for a graft. Segments II and III will be taken from the brother and then the backbench reconstruction of the graft will be performed, both a venous and arterial anastomosis. The orthotopic allotransplantation will then be performed on the patient.
What CPT® codes are reported?
A) 47140, 47146, 47147, 47135
B) 47141, 47146, 47135
C) 47140, 47147, 47146, 47399
D) 47141, 47146, 47399
A
Operative Report
Indications: This is a third follow-up EGD dilation on this 40 year-old patient for a pyloric channel ulcer which has been slow to heal with resulting pyloric stricture. This is a repeat evaluation and dilation.
Medications: Intravenous Versed 2 mg. Posterior pharyngeal Cetacaine spray.
Procedure: With the patient in the left lateral decubitus position, the Olympus GIFXQ10 was inserted into the proximal esophagus and advanced to the Z-line. The esophageal mucosa was unremarkable. Stomach was entered revealing normal gastric mucosa. Mild erythema was seen in the antrum. The pyloric channel was again widened. The ulcer, as previously seen, was well healed with a scar. The pyloric stricture was still present. With some probing, the 11 mm endoscope could be introduced into the second portion of the duodenum, revealing normal mucosa. Marked deformity and scarring was seen in the proximal bulb. Following the diagnostic exam, a 15 mm balloon was placed across the stricture, dilated to maximum pressure, and withdrawn. There was minimal bleeding post-op. Much easier access into the duodenum was accomplished after the dilation. Follow-up biopsies were also taken to evaluate Helicobacter noted on a previous exam. The patient tolerated the procedure well.
Impressions: Pyloric stricture secondary to healed pyloric channel ulcer, dilated.
Plan: Check on biopsy, continue Prilosec for at least another 30 days. At that time, a repeat endoscopy and final dilation will be accomplished. He will almost certainly need chronic H2 blocker therapy to avoid recurrence of this divesting complicated ulcer.
What CPT® and ICD-10-CM codes are reported?
A) 43245, 43239-51, K31.1, Z87.11
B) 43235, 43239-51, K31.4, Z87.19
C) 43248, 43239-59, K31.5, Z87.19
D) 43236, 43239-59, K31.1, Z87.11
B
A 57 year-old patient with chronic pancreatitis presents to the operating room for a pancreatic duct-jejunum anastomosis by the Puestow-type operation. What are the correct CPT® and ICD-10-CM codes for the encounter?
A) 48520, K85.80
B) 48548, K86.1
C) 48520, K86.1
D) 48548, K85.90
D
Procedure: Colectomy with a take-down of splenic flexure.
The patient was taken to the operating room, placed in the dorsal lithotomy position, and then prepped and draped in the usual sterile fashion. A vertical paramedian incision was made along the left side of the umbilicus from the symphysis and taken up to above the umbilicus. This incision was carried down to the rectus muscles, which were separated in the midline. The peritoneal cavity was entered with findings as described. The ascitic fluid was removed and hand-held retractors were used to assist in surgical exposure.
The malignant intra-abdominal tumor was resected from the hepatic flexure into the mid transverse colon. The resection was extended into the left upper quadrant and the attachments were also clamped, cut and suture ligated with 2-0 silk sutures in a stepwise fashion until mobilization of the tumor mass could be brought medial and hemostasis was obtained. Attempts to find a dissection plane between the malignant tumor mass and the transverse colon were unsuccessful as it appeared the tumor mass was invading into the wall of the bowel with extrinsic compression and distortion of the bowel lumen.
Given the mass could not be resected without removal of bowel, attention was directed to mobilization of the splenic flexure. Retroperitoneal dissection was started in the pelvis and continued along the left paracolic gutter. The ligamentous and peritoneal attachments were taken down with Bovie cautery in a stepwise fashion around the splenic flexure of the colon until the entire left colon was mobilized medially. Similar steps were then carried on the right side as the right colon and hepatic flexure were mobilized. The peritoneal and ligamentous attachments were taken down with Bovie cautery. Vascular attachments were clamped, cut, and suture ligated with 2-0 silk until the right colon was mobilized satisfactorily. The GIA stapler was introduced and fired at both ends to dissect the tumorous bowel free. The bowel was delivered off the operative field.
Attention was then directed towards re-anastomosis of the colon. Linen-shod clamps were used to gently clamp the proximal and distal segments of the large bowel. The staple line was removed with Metzenbaum scissors and the colon lumen was irrigated. The silk sutures were used to divide the circumference of the bowel into equal thirds, and the proximal and distal edges of the bowel were reapproximated with silk sutures. The posterior segment of the bowel was then retracted and secured with a TA stapler, ensuring a full thickness bowel wall insertion into the staple line. The additional two-thirds were also isolated and, with the TA stapler, clamped, ensuring that all layers of the bowel wall were incorporated into the anastomosis. A third staple line was fired and the integrity of the anastomosis was checked. First, complete hemostasis was noted. There was well beyond a finger width lumen within the large bowel. The linen-shod clamps were released and gas and bowel fluid were moved through the anastomosis aggressively with intact staple line; no leakage of gas or fluid. The abdomen was then irrigated and water was left over the anastomosis. The anastomosis was manipulated with no extravasation of air. The abdomen and pelvis were then irrigated aggressively. The Mesenteric trap was then re-approximated with interrupted 3-0 silk suture ligatures. All sites were inspected and noted to be hemostatic. Attention was directed towards closing.
Pathology report showed intra-abdominal cancer. Transverse colon and hepatic flexure cancer were also indicated. The origin of the cancer could not be determined from the specimen given.
What is the correct CPT® and ICD-10-CM coding for this report?
A) 44160, C18.8
B) 44140, C79.89, C78.5
C) 44147, 44139, C76.2, C18.8
D) 44140, 44139, C76.2, C18.8
D
A patient suffering from cirrhosis of the liver from alcohol abuse presents with a history of coffee ground emesis (bleeding). The surgeon diagnoses the patient with esophageal gastric varices. Two days later, in the hospital GI lab, the surgeon ligates the varices with bands via an UGI endoscopy. What CPT® and ICD-10-CM codes are reported?
A) 43400, I85.11, F10.10, K74.60
B) 43235, I83.008, F10.20, K70.30
C) 43205, K74.60, I85.01, F10.20
D) 43244, K70.30, I85.11, F10.10
C
Bile empties into the duodenum through what structure?
A) Pyloric sphincter
B) Biliary artery
C) Common bile duct
D) Common hepatic duct
B
What is the correct ICD-10-CM coding for diverticulosis of the small intestine which has been present since birth?
A) K57.90
B) Q43.8
C) K57.90, Q43.8
D) K57.10
D
A 7 year-old female presents to the same day surgery unit for a tonsillectomy. During the surgery the physician notices the adenoids are very inflamed and must be taken out as well. The adenoids, although not planned for removal, are removed following the tonsillectomy.
What CPT® code(s) is/are reported for the procedure?
A) 42825, 42830
B) 42821
C) 42825, 42835
D) 42820
C
A 45 year-old woman underwent a laparoscopic cholecystectomy. The procedure was performed for recurrent bouts of acute cholecystitis. What CPT® and ICD-10-CM codes are reported?
A) 47605, K81.2
B) 47570, K81.9
C) 47562, K81.0
D) 47600, K81.0
B
A 12 year-old patient had an adenoidectomy in 2013 and a second adenoidectomy this year. What CPT® code(s) is/are reported for the second adenoidectomy performed this year?
A) 42826
B) 42836
C) 42831, 42836
D) 42831
D
What CPT® code(s) is/are reported when a physician makes two separate incisions to perform a laparoscopic appendectomy and laparoscopic cholecystectomy?
A) 47562
B) 44960, 47562
C) 47562, 44970-51
D) 47562, 44970-59
B
What CPT® and ICD-10-CM codes are reported for a gastric restriction by placing a gastric band via laparoscopic surgery for an adult patient diagnosed as morbidly obese having a BMI of 43, type 2 uncontrolled diabetes and elevated blood sugar readings daily?
A) 43644, E66.9, Z68.41, E10.9
B) 43770, E66.01, Z68.41, E11.9
C) 43842, E66.01, Z68.41, E11.9
D) 43771, E66.01, Z68.41, E10.9
C
What CPT® code(s) is/are reported for an endoscopic direct placement of a percutaneous gastrostomy tube for a patient who previously underwent a partial esophagectomy?
A) 49440, 43116-51
B) 43246, 43116-51
C) 43246
D) 49440
D
What ICD-10-CM code is reported for acute gastritis with bleeding?
A) K29.70
B) K29.00
C) K29.71
D) K29.01
D
What CPT® and ICD-10-CM codes represent the creation of an opening into the stomach to insert a temporary feeding tube for nutritional support in an adult patient with proximal esophageal carcinoma due to alcohol dependence? A gastric tube was not created.
A) 43653, C15.9, F10.20
B) 43870, C15.8, F10.99
C) 43831, D49.0, F10.10
D) 43830, C15.3, F10.20
C
A patient is seen to have an esophageal motility procedure with acid perfusion study performed. What CPT® code(s) is/are reported?
A) 91010
B) 91030
C) 91010, 91013
D) 91020
C
What is the eponym for a pancreatoduodenectomy?
A) Meckel’s procedure
B) Hartmann’s procedure
C) Whipple procedure
D) Kasai procedure
B
A patient is seen in the ED for nausea and vomiting that has persisted for 4 days. The ED physician treats the patient for dehydration which is documented in the patient’s record as the final diagnosis. What ICD-10-CM code(s) is/are reported for this encounter?
A) R11.2, E86.0
B) E86.0
C) R11.10, R11.0, E86.0
D) R11.14
C
When reporting an encounter for screening of malignant neoplasms of the intestinal tract, what does the 5th character indicate?
A) History of malignancy in the intestinal tract.
B) Laterality of the intestinal tract.
C) Anatomic location being screened in the intestinal tract.
D) Screening codes for malignant neoplasms of the intestinal tract are only reported with four characters.
B
What is the term that describes the removal of a portion or all of the stomach?
A) Gastrotomy
B) Gastrectomy
C) Gastrostomy
D) Gastric bypass
CPT® code: 45330
ICD-10-CM code: K62.89
CASE 10
Extent of Examination: Proximal sigmoid colon. Reason(s) for Examination: Proctitis. Postoperative assessment: Proctitis.
Description of Procedure: Informed consent was obtained with the benefits, risks, including the risk of perforation and alternatives to sigmoidoscopy explained. The patient agreed to proceed. No contraindications were noted on physical exam. Patient was re-examined and no interval changes were noted from the preoperative history & physical. After being placed on the table, patient identification was verified prior to the procedure. Immediately prior to sedation for endoscopy the patient’s ASA classification was Class 2: Mild systemic disease. Monitored anesthesia care (MAC) was administered by the anesthesia team. The quality of the prep was adequate. Prior to the exam, a digital exam was performed and it was unremarkable.
The procedure was performed with the patient in the left lateral decubitus position. The sigmoidscope was inserted to the proximal sigmoid colon. In the rectum, a retroflex was performed. The withdrawal time from the proximal sigmoid colon was 8 minutes. The patient tolerated the procedure well.
There were no complications. The heart rate was normal. The oxygen saturation and skin color were normal. IV moderate sedation was administered under direct supervision of the physician. Upon discharge from the endoscopy area, the patient will be recovered per established procedures and protocols.
Findings: In the rectum, mild segmental inflammation with erythema was seen. There was no mucosal bleeding.
What are the CPT® and ICD-10-CM codes for this service?
CPT® code:
ICD-10-CM code:
CPT® code: 45378
ICD-10-CM codes: Z85.048, K52.9
CASE 9
Extent of Examination: Terminal ileum. Reason(s) for Examination: Hx of rectal cancer s/p Low Anterior Resection (LAR) and colonic J pouch for closure of loop ileostomy. Description of Procedure: Informed consent was obtained with the benefits, risks, including the risk of perforation and alternatives to colonoscopy explained. The patient agreed to proceed. No contraindications were noted on physical exam. Monitored anesthesia care (MAC) was administered. The bowel was prepared with Fleets enemas. The quality of the prep was fair. Prior to the endoscopic exam, a digital rectal exam was performed and it was unremarkable. The procedure was performed with the patient in the left lateral decubitus position. The cecum was identified by the ileocecal valve. The withdrawal time from the cecum was 7 minutes. The patient tolerated the procedure well. There were no complications. The exam was limited by poor preparation.
Findings: At the splenic flexure, moderate inflammation with erythema, granularity, friability, and hypervascularity was seen. There was no mucosal bleeding. In the proximal descending colon, moderate segmental inflammation with erythema, granularity, friability, and hypervascularity. In the rectum an abnormality was noted.
Anastomosis is patent and normal. No evidence of polyp. Just proximal prior to anastomosis – significant diffuse colitis was noted. What are the CPT® and ICD-10-CM codes for this service?
CPT® code:
ICD-10-CM codes (2):
CPT code: 45380
ICD-10-CM codes: D50.9, K64.8
CASE 8
Extent of Examination: Terminal ileum. Reason(s) for Examination: Anemia, Fe Deficiency Description of Procedure: Informed consent was obtained and I explained about the benefits, risks, including the risk of perforation and alternatives to colonoscopy. The patient agreed to proceed. No contraindications were noted on physical exam. Monitored anesthesia care (MAC) was administered by the anesthesia team. The bowel was prepared with GoLYTELY prep. The quality of the prep is based on the Ottawa bowel preparation quality scale. Total score: Right: 1 + Middle: 1 + Left: 1 + Fluid: 0 = 3/14. Prior to the exam, a digital exam was performed; hemorrhoids were noted.
The procedure was performed with the patient in the left lateral decubitus position. The instrument was inserted in the anus and advanced to the terminal ileum. The cecum was identified by the following: the ileocecal valve and the appendiceal orifice. In the rectum, a retroflex was performed. The patient tolerated the procedure well. There were no complications.
Findings: In the rectum, a few medium-size uncomplicated internal hemorrhoids were seen. The internal hemorrhoids were not bleeding. There was no evidence of inflammation, friability, granularity, or bleeding. Biopsy were taken. In the ascending colon and cecum there was mild granularity and red spots that were nonspecific and possibly due to air insufflation. No friability, ulcerations or bleeding. Biopsy taken. The remainder of the colon was normal. The terminal ileum was normal.
What are the CPT® and ICD-10-CM codes for this service?
CPT code:
ICD-10-CM codes (2):
CPT® code: 43235
ICD-10-CM code: K21.9
CASE 7
Extent of Examination: Upper gastrointestinal endoscopy. Reason(s) for Examination: Gastroesophageal Reflux Disease (GERD). Description of Procedure: Informed consent was obtained with the benefits, risks, including the risk of perforation and alternatives to upper GI endoscopy were explained. The patient agreed to proceed. No contraindications were noted on physical exam. Anesthesia was administered by the ICU staff. (See anesthesiologist report) Monitored anesthesia care (MAC) was administered by anesthesia team. The procedure was performed with the patient in the left lateral decubitus position. The instrument was inserted through the mouth to the second part of the duodenum. The patient tolerated the procedure well. There were no complications. The heart rate was normal. The oxygen saturation and skin color were normal. Upon discharge from the endoscopy area, the patient will be recovered per established procedures and protocols.
Findings: The esophagus was examined and no abnormalities were seen. The gastroesophageal junction (upper level of gastric folds) was located 40cm from the incisors. The stomach was examined and no abnormalities were seen. The small bowel was examined and no abnormalities were seen.
What are the CPT® and ICD-10-CM codes for this service?
CPT® code:
ICD-10-CM code:
CPT® code: 43644
ICD-10-CM codes: E66.01, I10, Z68.43
CASE 6
Preoperative Diagnosis: Severe obesity. Hypertension. BMI 53.
Postoperative Diagnosis: Severe obesity. Hypertension. BMI 53.
Procedure Performed: Laparoscopic antecolic Roux-en-Y gastric bypass with 150 alimentary limb, and a 40 cm biliopancreatic limb. Anesthesia: General endotracheal anesthesia. Operative Procedure: The patient was brought to the operating room and placed on the OR table in supine position. Once endotracheal anesthesia was achieved and pre-op antibiotics were given, the abdomen was prepped and draped in the standard surgical fashion. Access to the abdominal cavity was through a 1 cm supraumbilical incision with an Optiview trocar. CO2 was insufflated to achieve an intraabdominal pressure of approximately 15 mmHg. Accessory trocars were placed in the subxiphoid, right, mid and left upper quadrants of the abdomen, as well as in the right and left lower quadrants of the abdomen. All of this was done under appropriate videoscopic observation. The procedure begins with identification of the gastroesophageal junction and dissection of the angle of His. On the lesser curvature of the stomach, a window is dissected into the lesser sac. A linear stapler is passed, and the stomach is transected. Reinforcement of the staple line was done with Steri-Strips, creating a pouch approximately 50 cc in diameter. An Ewald tube is used to calibrate the pouch. At this point, the ligament of Treitz is identified and 40 cm from the ligament of Treitz, the small bowel was transected. The distal limb of the small bowel is then brought to the upper abdomen, and a side-to-side gastrojejunostomy between the pouch and the alimentary limb is performed with a linear stapler. The gastrojejunostomy site is then closed with a double layer of running 2-0 Vicryl sutures. The anastomosis was observed for leakage with air and Methylene blue. There was no evidence of leakage. I then proceeded 150 cm distal from the gastrojejunostomy. A side-to-side jejunojejunostomy was created between the biliopancreatic limb and alimentary limb. This was performed using two applications of the linear stapler. The jejunojejunostomy site was closed with several applications of the linear stapler. Hemoclips were applied to the suture line for hemostasis. Good hemostasis was evident. A 19 French Blake drain was placed over the gastrojejunal anastomosis. All trocars were removed under appropriate videoscopic observation. There was no evidence of bleeding from any of the trocar sites. The trocar sites were suture closed and injected with local anesthesia. The patient tolerated the procedure well. She was extubated on the OR table and transferred to the recovery room in stable condition. There were no complications.
What are the CPT® and ICD-10-CM codes for this service?
CPT® code:
ICD-10-CM codes (3):
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