Resolved Diverting ileostomy with laparoscopic colostomy

[LoganR_46098]

Hey CCO!

We have a patient with colostomy status who underwent a laparoscopic colostomy takedown along with low anterior resection and anastomosis but also a diverting ileostomy was created. I wanted to get some guidance in reporting the correct CPTs 44227, 44187 vs 44208, thank you!

 

[Alicia]

I think you are going to code each of these out. I didn't find much. In 2006 there was an April CPT Assistant Archive:

Code 44187, Laparoscopy, surgical; ileostomy or jejunostomy, non-tube, is indicated in patients with rectal injury such as a bladder fistula, rectovaginal fistula, or rectourethral fistula. It may also be indictated in patients with obstruction due to cancer of the colon or rectum, cancer of the small bowel, or carcinomatosis. This procedure is usually temporary. A parenthetical note has been added to direct users to the open procedure code 44310.
Because 44187 is often a temp procedure there is not going to be combo codes.

I also researched several sites. I can't find this exact scenerio which is odd because this is rather common.
Here is one example but not the same https://www.kzanow.com/coding-coach...tion-low-pelvic-anastomosis-partial-colectomy