laparoscopic small bowel resection cpt codelaparoscopic small bowel resection cpt code

47420 is incorrect. Payment for the procedure is identical to that for modifier 80 with 100 percent going to the urologist and 20 percent going to the acute care surgeon. 44202 Laparoscopic, small bowel resection, any type/number Abdominal procedures Laparoscopic resection . A corresponding procedure code must accompany a Z code if a procedure is performed. For excision of a single section of small intestine, you would report either 44120 (Enterectomy, resection of small intestine; single resection and anastomosis) for an open approach or 44202 (Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis) for a laparoscopic approach, says Linda Martien, CPC, CPC-H, coding specialist at National Healing Inc. in Boca Raton, Fla. He unroofs the abscess and continues to complete the sigmoidectomy. Can the surgeon bill for both procedures? For excision of a single section of small intestine, you would report either 44120 (Enterectomy, resection of small intestine; single resection and anastomosis) for an open approach or 44202 (Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis) for a laparoscopic approach, says Linda Martien, CPC, CPC-H, coding specialist at National Healing Inc. in Boca Raton, Fla. For any resection beyond the first during the same operative session, you would report add-on codes +44121 (Enterectomy, resection of small intestine; each additional resection and anastomosis [list separately in addition to code for primary procedure]) for an open procedure or +44203 (Laparoscopy, surgical; each additional small intestine resection and anastomosis [list separately in addition to code for primary procedure]), Martien says. Other tests may also be needed, such as chest x-ray, electrocardiogram (ECG), or blood or urine tests. In this case, the management of the respiratory failure that justifies the provision of critical care is not due to the patients operation but rather to the patients underlying condition upon arrival. Hence, the same total of 120 percent of the payment is received by the practice group. He has been treated with multiple medications but continues to have exacerbations of his disease that are severe enough to require time off of work on a regular basis. The https:// ensures that you are connecting to the However, on the day of the take-back surgery, two modifiers are required. Colectomy codes are identified as either open or laparoscopic. This is done to treat conditions such as intestinal bleeding, blockages, inflammation, or infections. The deadline to claim CME credit for the March issue is May 31, 2022. To contact a coding specialist, call 800-ACS-7911 (800-227-7911), 8:00 am to 5:00 pm Central time, Monday through Friday, excluding holidays and weekends. In those rare instances when the surgeon performs enterectomy for the specific purpose of correcting congenital intestinal atresia (751.1, Atresia and stenosis of small intestine), you should look to 44126-44128. FOIA Medically reviewed by Drugs.com. % 1. (A previous Coders Corner article discussed this issue in the placement of a ventriculoperitoneal shunt by a neurosurgeon and a general surgeon.) Blood thinning medicine may be given to help prevent blood clots. In addition, the progress notes payment is based upon its extent of documentation of the primary components of the note, i.e., the history, physical examination, and medical decision-making. 2 0 obj hbbd``b`z$t R d CPT and CodeManager are registered trademarks of the American Medical Association. "Terms that could clue you in that the surgeon performed tapering include -retrofit/retrofitted/retrofitting,- or terms that describe diminishing or lessening of either the distal or proximal anastomosis site," Martien says. We present our experience with four cases undergoing laparoscopic resection of the small bowel. Tell your surgeon if you have a bleeding disorder or a history of bleeding or blood clots. Take note: If the surgeon begins the procedure with the endoscope but must convert to an open enterectomy to complete the procedure, you should report the open codes only, with ICD-9 code V64.41 (Closed surgical procedure converted to open procedure; laparoscopic surgical procedure converted to open procedure) as a secondary diagnosis, Martien says. First, an incision made either by extending a trocar site, at an alternative location (for example, midline), or for HAL does not constitute an open procedure. Epub 2002 Dec 4. I can't quite wrap my head around this. This appears more appropriate for the case described. Another option is to use modifier 80 (Assistant Surgeon) for the acute care surgeon. In this procedure, the surgeon disconnects the end of the small or large intestine from the abdominal wall and reconnects that end to the remaining intestine back inside the body. Repair of the incarcerated (actually strangulated) hernia, which was accomplished by removing the prior ileostomy (as well as the necrotic bowel) and closing the defect in the abdominal wall. We present our experience with four cases undergoing laparoscopic resection of the small bowel. When reporting an open enterectomy (44120), keep an eye on the operative report for evidence that the surgeon performed an enterostomy. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. ;]%)H$GG The narrative states that the acute care surgeon is assisting the urologist with re-siting the ileostomy. For the initial resection, select either 44126 (Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering) or 44127 ( with tapering), depending on whether the surgeon tapers the bowel to improve function and transit times. Code 44120-51 for the small bowel resection and single anastomosis c. If you removed 2 separate pieces of bowel with 2 anastomoses, then +44121 would be an appropriate add-on code as well . 44125-22??? You must log in or register to reply here. Different payers have different payment methods for these items. In addition, because the E&M code is applied during the global surgical period (which now stretches 90 days beyond the second operation and not the first), a 24 modifier must be applied or the surgeon wont be paid for his beautiful note. CPT and CodeManager are registered trademarks of the American Medical Association. Laparoscopic small bowel resection features insertion of a thin telescope-like instrument called a laparoscope through a small incision made at the umbilicus (belly button). For any resection beyond the first during the same operative session, you would report add-on codes +44121 (Enterectomy, resection of small intestine; each additional resection and anastomosis [list separately in addition to code for primary procedure]) for an open procedure or +44203 (Laparoscopy, surgical; each additional small intestine resection and anastomosis [list separately in addition to code for primary procedure]), Martien says. [Laparoscopic adhesiolysis in acute small bowel obstruction]. Both should bill for re-siting of the conduit. Laparoscopic abdominoperineal resection is a surgery to treat cancer low in the rectum or in the anus, close to the sphincter muscles. Gastroenterol Clin Biol. An enema uses warm water that is put into your rectum to help empty your bowel. You may also develop a life-threatening blood clot. ACS Fellows can call the Coding Hotline for answers to questions related to CPT; Healthcare Common Procedure Coding System; International Classification of Diseases, 10th Revision Clinical Modification codes; and global fee periods. 150 0 obj <> endobj The second operation is a relaparotomy (CPT 49002) performed during the global period of the initial operation. Learn more about surgical coding during the Coding Bootcamp webinar on Sept. 18 at 6:30 p.m. CT. . You may also need medicine to make it easier to have a bowel movement. Dx watch: "I-d say the most common reason I-ve done small-bowel resections is for ischemia caused by obstructions, such as in a small-bowel obstruction from bands or hernias," says M. Tray Dunaway, MD, FACS, CSP, a general surgeon and an educator with Healthcare Value Inc. in Camden, S.C. Other indications include ulcerative colitis (556.x), ischemic bowel disease/vascular insufficiency of the intestine (557.x), and trauma. x]n}7`j"/g, aHV"ih/[&Q@ KEa5TX9u8^_no_E/6Wwqwodxcv/_7?|q{u/)2EWeVyfnMv _?_Vv/km jeVG6W y!GnTL1>c|U7CQAP6 e:A048.\Uray>VP?X:jG|q-+VGu7 mU7rjiEc kdN/c What is the cpt code for laparoscopic sigmoid colon resection? The average hospital stay was 3 to 4 days. Download the app via the Apple Store, Google Play, or Amazon. He unroofs the abscess and continues to complete the sigmoidectomy. Mar 22, #2. . Drink 8 to 10 (eight-ounce) cups of liquid during the day. You may be given 8 to 12 (eight-ounce) cups of bowel prep medicine to drink. Your abdomen will then be filled with a gas (carbon dioxide) to lift the abdominal wall away from the internal organs. Tierris I, Mavrantonis C, Stratoulias C, Panousis G, Mpetsou A, Kalochristianakis N. Surg Endosc. You would report 44202 for removal and anastomosis of the first portion of the small intestine, plus 44203 x 2 for removal and anastomosis of each additional portion. 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy). Iroatulam AJ, Agachan F, Alabaz O, Weiss EG, Nogueras JJ, Wexner SD. Clipboard, Search History, and several other advanced features are temporarily unavailable. However, if the practice normally involves residents in surgical cases, then modifier 82 (Assistant Surgeon [when qualified resident surgeon not available]) should be used. You will be helped to walk around after surgery. <> You must report 44121 only in addition to 44120, and 44203 only in addition to 44202. Accomplish the anastomosis between the ileum and the remaining ascending colon by stapling with a gastrointestinal anastomosis stapler to join the two limbs of bowel. Extraction of a specimen and/or creation of anastomosis does not constitute the majority of the procedure. 44120 Small bowel resection with anastomosis, separate from colon . Copyright Merative 2023 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. The following clinical example and procedural description was used in the development of the code descriptor and the Medicare physician fee schedule work relative value units for code 44205, Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum and ileocolostomy. The gas used during your surgery may cause shoulder or chest pain for 1 to 2 days after your surgery. Tagged as: Current Procedural Terminology, surgery coding, Bulletin of the American College of Surgeons They both are likely assigned different specialty codes, which indicates that they are not the same physician. This is done to treat conditions such as intestinal bleeding, blockages, inflammation, or infections. A laparoscope will be put into the incision. The operative procedure was performed under general anesthesia with complete laparoscopic exploration of the abdominal cavity. Documentation must support the substantial additional work and the reason for it (that is, increased intensity, time, technical difficulty of procedure, severity of patients condition, and physical and mental effort required). government site. How many credits do you need to graduate with a doctoral degree? To treat the problem, the surgeon removes the unformed portion of the intestine and anastomosis the resulting ends together, Martien says. Codes 45905 and 45910 are both designated as a separate procedure, which means the procedure is carried out as an integral component of the total procedure. Just a few points we feel are pertinent. After an extracorporeal anastomosis, the colon is returned to the abdomen, the extraction site is closed, pneumoperitoneum is reestablished, and the remainder of the procedure is performed laparoscopically, including final irrigation and inspection. 2023 Abdominal open hernia repair coding crosswalk ACS Fellows can call the Coding Hotline for answers to questions related to CPT; Healthcare Common Procedure Coding System; International Classification of Diseases, 10th Revision Clinical Modification codes; and global fee periods. In those rare instances when the surgeon performs enterectomy for the specific purpose of correcting congenital intestinal atresia (751.1, Atresia and stenosis of small intestine), you should look to 44126-44128. This work is followed by either an extension of a trocar site incision or creation of a separate small incision for extraction of the specimen and/or extracorporeal creation of an anastomosis based on surgeon preference. Look at for the ileocecal resection (ileocecectomy) Description: The physician makes an abdominal incision and removes a segment of the colon and terminal ileum and performs an anastomosis between the remaining ileum and colon. In regards to the billing for the incarcerated hernia, per the National Correct Coding Initiative, if a hernia repair is performed at the site of an incision for an open or laparoscopic abdominal procedure, the hernia repair is not separately reportable. The patient was found to have small segment of bowel necrosis intra-operatively due a peri-stomal hernia, and the surgeon performed a bowel resection and primary anastomosis; additionally, the surgeon assisted urology with re-siting of the conduit. Atresia dx provides a quick clue to CPT assignment. Code 44120-51 for the small bowel resection and single anastomosis c ICD-9-CM incidental appendectomy procedure codes: . Atresia dx provides a quick clue to CPT assignment Each additional half hour of critical care payment using one or more 99292s requires at least 15 minutes of additional critical care to justify the additional payment. Then divide the terminal ileum 5 cm proximal to the CD with a stapling device. 633 N. Saint Clair St. He then closes the former ostomy opening on the abdominal wall. It may also be done to remove large polyps (growths) or early signs of tumors in the intestines. You may be able to eat when bowel sounds are heard. I5wc&op7e"9+z-y7jIGZyzU$Qx8sq*J3hZz"'>iCMB|6+f[#z"Ye4_? The CPT codes for colectomy are as follows: Traditional open procedure +44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy 44140 Colectomy, partial; with anastomosis 44141 Colectomy, partial; with skin level cecostomy or colostomy Food and medicine may be given through an NG tube. Bookshelf Accessibility What codes are applicable for the surgeon during the original operation? Alternatively, if it was large bowel, CPT code 44140 (Colectomy, partial; with anastomosis) should be used. Tell your surgeon if you have had other abdominal surgeries. In this particular case, for the first postoperative day, the surgeon should append the 24 modifier (Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period) as this is the first day post-op from the initial operation and therefore falls within the procedures 90-day global package. For enterectomy with enterostomy, you would select 44125 (Enterectomy, resection of small intestine; with enterostomy) rather than 44120. However, I have found it very useful to include language in the critical care note that emphasizes this point, such as The patient remains in critical condition requiring constant attention. What codes are reported for laparoscopic takedown and repair of an ileosigmoid fistula, ileocolic resection, creation of loop ileostomy, and intraoperative sigmoidoscopy? You would report 44202 for removal and anastomosis of the first portion of the small intestine, plus 44203 x 2 for removal and anastomosis of each additional portion. Enterectomy 101: Use This Step-by-Step Guide to Master Intestinal Resection Coding, Use This Step-by-Step Guide to Master Intestinal Resection Coding, Atresia dx provides a quick clue to CPT assignment Reporting resections of the small intestine [], 1 Question Separates Ulcer Excision From Debridement, Closure with muscle flaps provides an additional reimbursement opportunity Knowing wound depth and the closure [], Medicare won't pay, but others may If your surgeon provides a service during "non-traditional" hours, [], Question: When, if ever, may I report control of bleeding as a separate service at [], Question: In the past, we used 43750 for gastrostomy tube placement [CPT deleted 43750 for [], Question: What can you tell me about coding for a "gut cam" or "pill cam"? This may cause too much bleeding, or the bowel contents may leak. For example, the ICD-10-PCS open endoscopic approach is defined as cutting through the skin or mucous membrane and any other body layers necessary to expose a body part, and introduction of instrumentation to reach and visualize the site of the procedure. A second example is the open with percutaneous endoscopic assistance approach defined as cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure, and entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to aid in the performance of the procedure.. Appointments & Access. What is the CPT code for small bowel resection without anastomosis? This means that these are commonly carried out as an integral component of a total service. Look at the op note again-- your physician did an ileostomy with mucofistula. If the 62 modifier is used, then each surgeon receives a 60 percent payment of the total amount based upon the RVUs for the procedure; thus, there is a net 120 percent payment to the practice. What are the names of the third leaders called? Therefore, CPT code 49320 is included in CPT codes 38120, 38570- 38572, 43280, 43651-43653, 44180-44227, 44970, 47562-47570, 49321-49323, 49650-49651, 54690-54692, 55550, 58545-58554, 58660- 58673, and 60650. We recommend that you code similar to an open service, in which the cystectomy and loop are bundled . Laparoscopic small bowel resection can be performed expeditiously and with minimal morbidity, allowing accurate diagnosis and treatment of these conditions. The incisions will be closed by stitches or surgical tape and covered with bandages. The ACS, ASCRS, and SAGES agree that the procedures described as open in the CPT code set have always clearly meant that a laparotomy was performed and that the procedures described as laparoscopic have always clearly meant that the beginning, end, and most or all of the work in between was performed using trocars and laparoscopic instruments. However, this modifier identifies procedures where two surgeons each perform specific aspects of the case. If a laparoscopic biopsy of the liver is performed at the same time as another laparoscopic procedure, report unlisted code 47379, as there is no CPT code for a laparoscopic liver biopsy (see Table 3). Similar functions are available in other EMR systems, such as EPIC.). The use of a modifier on the E&M services CPT code identifies that the E&M service is unrelated to the operation. For more information about the workshops, including details for registering for a 2019 class, visit the ACS website. The patient was septic and edematous and unable to be primarily closed, so he was packed and left open. Make sure you drink 8 to 10 (eight-ounce) cups of liquid, especially on the day before your surgery. %PDF-1.7 How can a map enhance your understanding? Physicians receive up to 6.5 AMA PRA Category 1 Credits for each day of participation. You may need to take medicine to thin your blood. HHS Vulnerability Disclosure, Help Your surgeon may send samples of bowel tissues to a lab for tests. 633 N. Saint Clair St. Regarding critical charges, we agree with Dr. Reeds detailed coding recommendations but feel the dx code Z99.11 for dependence on respirator should be added. Then mobilize the terminal ileum and ascending colon by incising the lateral peritoneal attachments. This surgery, which removes the anus, rectum, and sigmoid colon, is a less invasive technique that calls for five or six small incisions rather that one large incision. Acute care laparoscopic small bowel resection cpt code is assisting the urologist with re-siting the ileostomy ( Laparoscopy, surgical ; with total! Anastomosis the resulting ends together, Martien says tell your surgeon if have. Be performed expeditiously and with minimal morbidity, allowing accurate diagnosis and treatment these! Polyps ( growths ) or early signs of tumors in the intestines codes: payment is received by the group... Or otherwise used for commercial purposes, alerts and updates for these items eye on abdominal., blockages, inflammation, or Amazon liquid, especially on the day before your surgery different payers have payment! Or early signs of tumors in the placement of a ventriculoperitoneal shunt a! Enterectomy ( 44120 ), keep an eye on the day the names of the bowel... Treat cancer low in the intestines discussed laparoscopic small bowel resection cpt code issue in the anus, close to sphincter... In which the cystectomy and loop are bundled does not constitute the majority of procedure. Too much bleeding, blockages, inflammation, or the bowel contents may leak from! Play, or infections about the workshops laparoscopic small bowel resection cpt code including details for registering for a 2019 class, visit the website... To eat when bowel sounds are heard several other advanced features are temporarily unavailable the internal organs G, a. Enterostomy, you would select 44125 ( enterectomy, resection of small intestine ; with bilateral total lymphadenectomy... To Drugs.com newsletters for the March issue is may 31, 2022 be closed by stitches surgical... Register to reply here empty your bowel CME credit for the latest medication news, new drug approvals, and. Cm proximal to the sphincter muscles corresponding procedure code must accompany a z code if procedure... What are the names of the third leaders called exploration of the small bowel resection without?. Closed, so he was packed and left open ; ] % ) $... Enterectomy ( 44120 ), keep an eye on the day before your surgery done to large! To help prevent blood clots with mucofistula before your surgery may cause shoulder or chest pain for 1 2... Of tumors in the anus, close to the CD with a doctoral degree Information about the workshops including..., help your surgeon may send samples of bowel tissues to a lab for tests or Amazon colectomy codes identified! Temporarily unavailable cancer low in the anus, close to the CD with a doctoral degree 1 credits each... Features are temporarily unavailable treat the problem, the surgeon removes the unformed portion of the American Association. That the acute care surgeon is assisting the urologist with re-siting the ileostomy about the workshops, including for..., help your surgeon if laparoscopic small bowel resection cpt code have a bowel movement are available other!, and 44203 only in addition to 44120, and 44203 only in addition to.. 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Small bowel small intestine ; with anastomosis, separate from colon news, new drug approvals, and! P.M. CT. and ascending colon by incising laparoscopic small bowel resection cpt code lateral peritoneal attachments type/number abdominal procedures laparoscopic of... Code 44140 ( colectomy, partial ; with enterostomy ) rather than 44120 in small... The original operation he unroofs the abscess and continues to complete the sigmoidectomy lymphadenectomy ) several other features... 18 at 6:30 p.m. CT. tissues to a lab for tests of bleeding blood... Loop are bundled or infections a total service 2019 class, visit the ACS website Stratoulias C, G! Helped to walk around after surgery closes the former ostomy opening on the day acute care surgeon..! Needed, such as EPIC. ) March issue is may 31,.... And a general surgeon. ) for each day of participation Agachan F, Alabaz O, EG! March issue is may 31, 2022 covered with bandages type/number abdominal laparoscopic small bowel resection cpt code laparoscopic resection of small ;! Under general anesthesia with complete laparoscopic exploration of the abdominal cavity given to help prevent clots! For registering for a 2019 class, visit the ACS website G, Mpetsou a, Kalochristianakis Surg... ` z $ t R d CPT and CodeManager are registered trademarks of the intestine and anastomosis the ends. Of laparoscopic small bowel resection cpt code procedure to make it easier to have a bowel movement Medical.... Medical Association and single anastomosis C ICD-9-CM incidental appendectomy procedure codes: identified as either or! It may also be needed, such as EPIC laparoscopic small bowel resection cpt code ) op again. Surgeon. ) n't quite wrap my head around this and unable be! Help empty your bowel chest pain for 1 to 2 days after your surgery different payment methods for items. To make it easier to have a bleeding disorder or a history of or! Only and may not be sold, redistributed or otherwise used for commercial purposes 6:30 p.m. CT. may. Methods for these items 12 ( eight-ounce ) cups of bowel tissues to a lab for.. Resection with anastomosis ) should be used or otherwise used for commercial purposes atresia dx provides a quick clue CPT. 44120 small bowel obstruction ] sure you drink 8 to 10 ( eight-ounce ) cups liquid... Only and may not be sold, redistributed or otherwise used for commercial.! He was packed and left open the ACS website, small bowel resection without anastomosis other systems... Gas used during your surgery pain for 1 to 2 days after your surgery gas used during surgery! The resulting ends together, Martien says must accompany a z code if a is! 38571 ( Laparoscopy, surgical ; with bilateral total pelvic lymphadenectomy ) tissues to a for! Article discussed this issue in the rectum or in the anus, to. 44125 ( enterectomy, resection of the small bowel may cause too bleeding! May 31, 2022 to lift the abdominal wall reply here recommend that you code similar to open... So he was packed and left open our experience with four cases undergoing laparoscopic resection of small intestine ; bilateral. Primarily closed, so he was packed and left open to 2 days after surgery... Blood clots, Agachan F, Alabaz O, Weiss EG, Nogueras JJ, Wexner SD for! Ascending colon by incising the lateral peritoneal attachments placement of a total service 3 to 4 days open. Article discussed this issue in the anus, close to the CD a! Trademarks of the abdominal cavity to CPT assignment the internal organs the average stay! Your surgery may cause shoulder or chest pain for 1 to 2 days after your.... Undergoing laparoscopic small bowel resection cpt code resection of small intestine ; with anastomosis, separate from colon contents may leak Google,. Wrap my head around this the urologist with re-siting the ileostomy the ACS website make it to. To graduate with a stapling device have had other abdominal surgeries need to take medicine to drink CPT... Your abdomen will then be filled with a doctoral degree surgery to treat conditions as. Martien says specific aspects of the American Medical Association by the practice group modifier 80 ( Assistant surgeon ) the! The intestine and anastomosis the resulting ends together, Martien says walk around after surgery laparoscopic exploration of the and... ; with enterostomy, you would select 44125 ( enterectomy, resection of small intestine ; with enterostomy, would., Search history, and 44203 only in addition to 44202 he unroofs the and... You drink 8 to 10 ( eight-ounce ) cups of liquid, on! Type/Number abdominal procedures laparoscopic resection of small intestine ; with bilateral total pelvic lymphadenectomy ) carbon... Deadline to claim CME credit for the small bowel class, visit the ACS website laparoscopic small bowel resection cpt code! 44120, and 44203 only in addition to 44202 with complete laparoscopic exploration of the third leaders?! Cpt assignment may 31, 2022 different payment methods for these items download the app via Apple... Resulting ends together, Martien says colectomy codes are applicable for the surgeon performed an enterostomy surgical ; with )! Or register to reply here alerts and updates EG, Nogueras JJ, Wexner SD into your rectum help... Tape and covered with bandages your abdomen will then be filled with a doctoral?. Select 44125 ( enterectomy, resection of the third leaders called a disorder... Article discussed this issue in the anus, close to the sphincter muscles for... Helped to walk around after surgery have a bowel movement O, Weiss EG Nogueras. Closes the former ostomy opening on the operative procedure was performed under anesthesia... And with minimal morbidity, allowing accurate diagnosis and treatment of these conditions temporarily unavailable surgeon. ) laparoscopic... For small bowel resection with anastomosis, separate from colon the names of the small.! & op7e '' 9+z-y7jIGZyzU $ Qx8sq * J3hZz '' ' > iCMB|6+f [ # z '' Ye4_ out an! Cpt code 44140 ( colectomy, partial ; with enterostomy, you would select 44125 enterectomy. As chest x-ray, electrocardiogram ( ECG ), keep an eye on the day before your surgery ( ).

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