Takedown of Hartmann's Procedure

dorie.douthit@trinity-health.orgdorie.douthit@trinity-health.org
in Clinical & Coding

Patient presents for takedown of Hartmann's procedure. Per operative note,

An elliptical incision was made around the stoma. The stoma and portion of bowel coming through the abdominal wall was freed up using electrocautery as well as Metzenbaum scissors. Once this was completely mobilized, it was passed back into the abdominal cavity. The proximal portion of the bowel was then placed adjacent to the rectal stump and found to be of adequate length. A 65 mm long pursestring suture device was placed proximal to the stoma. The stoma was transected and passed off the table as a specimen.

Per coding clinic this is a reposition but per operative note the stoma was transected and pathology confirms two rings were submitted. Can you code the resection of the large bowel? Or do you only code the reposition? Thank you.


Comments

  • jc85054jc85054
    We code these to reposition only. Drives the DRG to 344-346 instead of 329-331. This does not make sense to me since the Reversal of a Hartmann's is more complex than a regular takedown and it is going to Minor Bowel instead of Major Bowel DRG.
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