DOCSLIB.ORG

2015 Colorectal Surgery Medicare Reimbursement Coding Guide Effective January 1, 2015

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
2015 Colorectal Surgery Medicare Reimbursement Coding Guide Effective January 1, 2015 2015 Colorectal Surgery Medicare Reimbursement Coding Guide Effective January 1, 2015 MEDICARE NATIONAL AVERAGE RATES AND ALLOWABLES (NOT ADJUSTED FOR GEOGRAPHY) AMBULATORY Physician HOSPITAL OUPATIENT SURGICAL CENTER CPT™* *MPFS APC APC **APC HCPCS Procedure Description (CF=$35.7547) ***ASC Classification Descriptor Rate Code Fac/Non-Fac COLECTOMY 44140 Colectomy, partial; with anastomosis $1,388.36 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare 44141 Colectomy, partial; with skin level cecostomy or colostomy $1,888.92 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Colectomy, partial; with end colostomy and closure of distal 44143 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare segment (Hartmann type procedure) $1,723.02 Colectomy, partial; with resection, with colostomy or 44144 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare ileostomy and creation of mucofistula $1,832.43 Colectomy, partial; with coloproctostomy (low pelvic 44145 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare anastomosis) $1,716.23 Colectomy, partial; with coloproctostomy (low pelvic 44146 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare anastomosis), with colostomy $2,197.84 44147 Colectomy, partial; abdominal and transanal approach $2,013.35 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Colectomy, total, abdominal, without proctectomy; with 44150 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare ileostomy or ileoproctostomy $1,936.83 Colectomy, total, abdominal, without proctectomy; with 44151 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare continent ileostomy $2,228.59 Colectomy, total, abdominal, with proctectomy; with 44155 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare ileostomy $2,153.51 Colectomy, total, abdominal, with proctectomy; with 44156 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare continent ileostomy $2,397.35 Colectomy, total, abdominal, with proctectomy; with 44157 ileoanal anastomosis, includes loop ileostomy, and rectal $2,260.77 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare mucosectomy, when performed Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (S or J), 44158 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare includes loop ileostomy, and rectal mucosectomy, when $2,191.05 performed Colectomy, partial, with removal of terminal ileum with 44160 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare ileocolostomy $1,284.67 44204 Laparoscopy, surgical; colectomy, partial, with anastomosis $1,592.51 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Page 1 of 8 2015 Reimbursement Guide Colorectal Surgery Page 2 of 8 AMBULATORY Physician HOSPITAL OUPATIENT SURGICAL CENTER CPT™* *MPFS APC APC **APC HCPCS Procedure Description (CF=$35.7547) ***ASC Classification Descriptor Rate Code Fac/Non-Fac Laparoscopy, surgical; colectomy, partial, with removal of 44205 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare terminal ileum with ileocolostomy $1,385.49 Laparoscopy, surgical; colectomy, partial, with end colostomy 44206 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare and closure of distal segment (Hartmann type procedure) $1,815.98 Laparoscopy, surgical; colectomy, partial, with anastomosis, 44207 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare with coloproctostomy (low pelvic anastomosis) $1,887.13 Laparoscopy, surgical; colectomy, partial, with anastomosis, 44208 with coloproctostomy (low pelvic anastomosis) with $2,061.62 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare colostomy Laparoscopy, surgical; colectomy, total, abdominal, without 44210 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare proctectomy, with ileostomy or ileoproctostomy $1,844.58 Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal 44211 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare reservoir (S or J), with loop ileostomy, includes rectal $2,252.19 mucosectomy, when performed Laparoscopy, surgical; colectomy, total, abdominal, with 44212 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare proctectomy, with ileostomy $2,124.54 COLOSTOMY 44188 Laparoscopy, surgical, colostomy or skin level cecostomy $1,267.50 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Laparoscopy, surgical; colectomy, partial, with end colostomy 44206 $1,815.98 and closure of distal segment (Hartmann type procedure) Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Laparoscopy, surgical; colectomy, partial, with anastomosis, 44208 with coloproctostomy (low pelvic anastomosis) with $2,061.62 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare colostomy Ureterosigmoidostomy, with creation of sigmoid bladder 50810 and establishment of abdominal or perianal colostomy, $1,444.85 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare including intestine anastomosis Closure of rectovaginal fistula; abdominal approach, with 57307 $1,106.97 cocomitant colostomy Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare EXTERIORIZATION OF INTESTINE 44125 Enterectomy resection of small intestine; with enteroscopy $1,221.38 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Enteroenterostomy, anastomosis of intestine, with or 44130 $1,357.96 without cutaneous enterostomy (separate procedure) Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare Laparoscopy, surgical, closure of enterostomy, large or small 44227 $1,728.38 intestine, with resection and anastomosis Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare HEMORRHOID Level II Urinary 46083 Incision of thrombosed hemorrhoid, external $109.41 / 0164 and Anal $213.78 $117.14 $179.49 Procedures Level II Anal/ 46220 Excision of single external papilla or tag, anus $122.64 / 0155 $1,455.16 $797.36 $210.95 Rectal Procedures Level I Anal/Rectal 46221 Hemorrhoidectomy, internal, by rubber band ligation(s) $197.72 / 0148 $442.51 $178.77 $276.38 Procedures Level II Anal/ 46230 Excision of multiple external papillae or tags, anus $178.42 / 0155 $1,455.16 $797.36 $279.24 Rectal Procedures Level III Anal/ 46250 Hemorrhoidectomy, external, 2 or more columns/groups $323.94 / 0149 $1,941.43 $1,063.82 $474.46 Rectal Procedures Hemorrhoidectomy, internal and external, single column/ Level III Anal/ 46255 $364.34 / 0149 $1,941.43 $1,063.82 group; $519.87 Rectal Procedures Hemorrhoidectomy, internal and external, single column/ Level III Anal/ 46257 0149 $1,941.43 $1,063.82 group; with fissurectomy $433.35 Rectal Procedures Hemorrhoidectomy, internal and external, single column/ Level III Anal/ 46258 group; with fistulectomy, including fissurectomy, when 0149 $1,941.43 $1,063.82 $480.19 Rectal Procedures performed 2015 Reimbursement Guide Colorectal Surgery Page 3 of 8 AMBULATORY Physician HOSPITAL OUPATIENT SURGICAL CENTER CPT™* *MPFS APC APC **APC HCPCS Procedure Description (CF=$35.7547) ***ASC Classification Descriptor Rate Code Fac/Non-Fac Hemorrhoidectomy, internal and external, 2 or more Level III Anal/ 46260 0149 $1,941.43 $1,063.82 columns/groups; $490.20 Rectal Procedures Hemorrhoidectomy, internal and external, 2 or more Level III Anal/ 46261 0149 $1,941.43 $1,063.82 columns/groups; with fissurectomy $536.68 Rectal Procedures Hemorrhoidectomy, internal and external, 2 or more Level III Anal/ 46262 columns/groups; with fistulectomy, including fissurectomy, 0149 $1,941.43 $1,063.82 $570.65 Rectal Procedures when performed Destruction of internal hemorrhoid(s) by thermal energy (eg, Level I Anal/Rectal 46930 $152.67 / 0148 $442.51 $145.52 infrared coagulation, cautery, radiofrequency) $211.31 Procedures Hemorrhoidectomy, internal, by ligation other than rubber Level III Anal/ 46945 $232.05 / 0149 $1,941.43 $222.39 band; single hemorrhoid column/group $316.07 Rectal Procedures Hemorrhoidectomy, internal, by ligation other than rubber Level III Anal/ 46946 $233.12 / 0149 $1,941.43 $1,063.82 band; 2 or more hemorrhoid columns/groups $322.86 Rectal Procedures Level I Anal/Rectal Not reimbursed 46999 Unlisted procedure, anus 0148 $442.51 Carrier priced Procedures in ASC by Medicare HERNIA REPAIR Revision of colostomy; with repair of paracolostomy hernia 44346 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare (separate procedure) $1,223.53 ILEOSTOMY Laparoscopy, surgical; jejunostomy (eg, for decompression Level II Not reimbursed in 44186 $674.69 0131 $3,779.40 or feeding) Laparoscopy ASC by Medicare 44187 Laparoscopy, surgical; ileostomy or jejunostomy, non-tube $1,146.30 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare 45136 Excision of ileoanal reservoir with ileostomy $1,865.32 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare INTESTINAL ANASTOMOSIS Revision of gastrojejunal anastomosis (gastrojejunostomy) 43860 with reconstruction, with or without partial gastrectomy or $1,694.77 Inpatient Procedures, not reimbursed in outpatient or ASC by Medicare intestine resection; without vagotomy Revision of gastrojejunal anastomosis (gastrojejunostomy) 43865 with reconstruction, with or without partial
Load more

Recommended publications
  • Curative Pelvic Exenteration for Recurrent Cervical Carcinoma in the Era of Concurrent Chemotherapy and Radiation Therapy
    Available online at www.sciencedirect.com ScienceDirect EJSO xx (2015) 1e11 www.ejso.com Review Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review H. Sardain a,b, V. Lavoue a,b,c,*, M. Redpath d, N. Bertheuil b,e, F. Foucher a,J.Lev^eque a,b,c a CHU de Rennes, Gynecology Department, Tertiary Surgery Center, Teaching Hospital of Rennes, Hopital^ Sud, 16, Bd de Bulgarie, 35000 Rennes, France b Universite de Rennes, Faculty of Medicine, 2 Henry Guilloux, 35000 Rennes, France c INSERM, ER440, Oncogenesis, Stress and Signaling (OSS), Rennes, France d McGill University, Department of Pathology, Jewish General Hospital, Cote^ Sainte Catherine, Montreal, QC, Canada e CHU de Rennes, Department of Plastic, Reconstructive and Aesthetic Surgery, Tertiary Surgery Center, Teaching Hospital of Rennes, Hopital^ Sud, 16, Bd de Bulgarie, 35000 Rennes, France Accepted 26 March 2015 Available online --- Abstract Objective: Pelvic exenteration requires complete resection of the tumor with negative margins to be considered a curative surgery. The pur- pose of this review is to assess the optimal preoperative evaluation and surgical approach in patients with recurrent cervical cancer to in- crease the chances of achieving a curative surgery with decreased morbidity and mortality in the era of concurrent chemoradiotherapy. Methods: Review of English publications pertaining to cervical cancer within the last 25 years were included using PubMed and Cochrane Library searches. Results: Modern imaging (MRI and PET-CT) does not accurately identify local extension of microscopic disease and is inadequate for pre- operative planning of extent of resection.
    [Show full text]
  • Laparoscopic Truncal Vagotomy and Gatrojejunostomy for Pyloric Stenosis
    ORIGINAL ARTICLE pISSN 2234-778X •eISSN 2234-5248 J Minim Invasive Surg 2015;18(2):48-52 Journal of Minimally Invasive Surgery Laparoscopic Truncal Vagotomy and Gatrojejunostomy for Pyloric Stenosis Jung-Wook Suh, M.D.1, Ye Seob Jee, M.D., Ph.D.1,2 Department of Surgery, 1Dankook University Hospital, 2Dankook University School of Medicine, Cheonan, Korea Purpose: Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and Received January 27, 2015 an important target for surgical treatment. Laparoscopy applies to most surgical procedures; however Revised 1st March 9, 2015 its use in elective peptic ulcer surgery, particularly in cases of pyloric stenosis, has not been popular. 2nd March 28, 2015 The aim of this study was to describe the role of laparoscopic surgery and an easily performed Accepted April 20, 2015 procedure for pyloric stenosis. We accordingly performed laparoscopic truncal vagotomy with gastrojejunostomy in 10 consecutive patients with pyloric stenosis. Corresponding author Ye Seob Jee Methods: Data were collected prospectively from all patients who underwent laparoscopic truncal Department of Surgery, Dankook vagotomy with gastrojejunostomy from August 2009 to May 2014 and reviewed retrospectively. University Hospital, Dankook Results: A total of 10 patients underwent laparoscopic trucal vagotomy with gastrojejunostomy for University School of Medicine, 119, peptic ulcer obstruction from August 2009 to May 2014 in ○○ university hospital. The mean age was Dandae-ro, Dongnam-gu, Cheonan 62.6 (±16.4) years old and mean BMI was 19.3 (±2.5) kg/m2. There were no conversions to open 330-714, Korea surgery and no occurrence of intra-operative complications.
    [Show full text]
  • Thoracoscopic Truncal Vagotomy Versus Surgical Revision of the Gastrojejunal Anastomosis for Recalcitrant Marginal Ulcers
    Surgical Endoscopy (2019) 33:607–611 and Other Interventional Techniques https://doi.org/10.1007/s00464-018-6386-7 2018 SAGES ORAL DYNAMIC Thoracoscopic truncal vagotomy versus surgical revision of the gastrojejunal anastomosis for recalcitrant marginal ulcers Alicia Bonanno1 · Brandon Tieu2 · Elizabeth Dewey1 · Farah Husain3 Received: 1 May 2018 / Accepted: 10 August 2018 / Published online: 21 August 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Introduction Marginal ulcer is a common complication following Roux-en-Y gastric bypass with incidence rates between 1 and 16%. Most marginal ulcers resolve with medical management and lifestyle changes, but in the rare case of a non-healing marginal ulcer there are few treatment options. Revision of the gastrojejunal (GJ) anastomosis carries significant morbidity with complication rates ranging from 10 to 50%. Thoracoscopic truncal vagotomy (TTV) may be a safer alternative with decreased operative times. The purpose of this study is to evaluate the safety and effectiveness of TTV in comparison to GJ revision for treatment of recalcitrant marginal ulcers. Methods A retrospective chart review of patients who required surgical intervention for non-healing marginal ulcers was performed from 1 September 2012 to 1 September 2017. All underwent medical therapy along with lifestyle changes prior to intervention and had preoperative EGD that demonstrated a recalcitrant marginal ulcer. Revision of the GJ anastomosis or TTV was performed. Data collected included operative time, ulcer recurrence, morbidity rate, and mortality rate. Results Twenty patients were identified who underwent either GJ revision (n = 13) or TTV (n = 7). There were no 30-day mortalities in either group.
    [Show full text]
  • Effects of Sleeve Gastrectomy Plus Trunk Vagotomy Compared with Sleeve Gastrectomy on Glucose Metabolism in Diabetic Rats
    Submit a Manuscript: http://www.f6publishing.com World J Gastroenterol 2017 May 14; 23(18): 3269-3278 DOI: 10.3748/wjg.v23.i18.3269 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ORIGINAL ARTICLE Basic Study Effects of sleeve gastrectomy plus trunk vagotomy compared with sleeve gastrectomy on glucose metabolism in diabetic rats Teng Liu, Ming-Wei Zhong, Yi Liu, Xin Huang, Yu-Gang Cheng, Ke-Xin Wang, Shao-Zhuang Liu, San-Yuan Hu Teng Liu, Ming-Wei Zhong, Xin Huang, Yu-Gang Cheng, reviewers. It is distributed in accordance with the Creative Ke-Xin Wang, Shao-Zhuang Liu, San-Yuan Hu, Department Commons Attribution Non Commercial (CC BY-NC 4.0) license, of General Surgery, Qilu Hospital of Shandong University, Jinan which permits others to distribute, remix, adapt, build upon this 250012, Shandong Province, China work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and Yi Liu, Health and Family Planning Commission of Shandong the use is non-commercial. See: http://creativecommons.org/ Provincial Medical Guidance Center, Jinan 250012, Shandong licenses/by-nc/4.0/ Province, China Manuscript source: Unsolicited manuscript Author contributions: Liu T, Liu SZ and Hu SY designed the study and wrote the manuscript; Liu T and Zhong MW instructed Correspondence to: San-Yuan Hu, Professor, Department of on the whole study and prepared the figures; Liu Y and Wang KX General Surgery, Qilu Hospital of Shandong University, No. 107, collected and analyzed the data; Liu T, Huang X and Cheng YG Wenhua Xi Road, Jinan 250012, Shandong Province, performed the operations and performed the observational study; China.
    [Show full text]
  • Pelvic Exenteration for the Management of Pelvic Malignancies
    Chapter 7 Pelvic Exenteration for the Management of Pelvic Malignancies Daniel Paramythiotis, Konstantinia Kofina and Antonios Michalopoulos Additional information is available at the end of the chapter http://dx.doi.org/10.5772/61083 Abstract Pelvic exenteration is a surgical procedure first described by Brunschwig in 1948 as a curative or palliative treatment for pelvic and perineal tumors. It is actually a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In patients with recurrent cervical and vaginal malignancy, it is associated with a 5-year survival of more than 50%. In spite of advances in surgical management, consequences such as stomas, are still frequently unavoidable for radical tumor excision. Most candidates for this procedure have been diagnosed with recurrent cervical cancer that has previously been treated with surgery and radiation, or radiation alone. Complications of pelvic exenteration are more severe than those of standard resection of a colorectal carcinoma, so it is not commonly performed, including wound infection, wound dehiscence (also described as burst abdomen) the creation of fistulae (perineal-fecal, uretero-vaginal, between conduit and perineal wound), urinary tract infections, perineal hernias and intestinal obstruction. Patients need to be carefully selected and counseled about risks and long-term issues related to the surgery. A comprehensive evaluation is required in order to exclude unresectable or metastatic disease. Evolution of the technique through laparoscopy and minimally invasive surgery may result in a reduction of morbidity and mortality. Keywords: Pelvic exenteration, gynecologic cancer 1. Introduction Pelvic exenteration was first described by Brunschwig and his colleagues of New York’s Memorial Hospital in 1948 [1] and was initially performed as a palliative surgical intervention © 2015 The Author(s).
    [Show full text]
  • A Matched Cohort Analysis of Single Anastomosis Loop Duodenal Switch Versus Roux-En-Y Gastric Bypass with 18-Month Follow-Up - Springer
    A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up - Springer Search Submit Article Surgical Endoscopy pp 1-7 First online: 22 December 2015 A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up Austin Cottam, Daniel Cottam , Walter Medlin, Christina Richards, Samuel Cottam, Hinali Zaveri, Amit Surve 10.1007/s00464-015-4707-7 Copyright information Abstract Background The Roux-en-Y gastric bypass (GBP) has been considered the gold standard for many years. The loop duodenal switch (LDS) is a relatively new procedure that simplifies the complexity of the duodenal switch (BPDDS) by making it a single anastomosis procedure while at the same time giving it more intestinal absorption to reduce the rates of malnutrition associated with traditional BPDDS. This paper seeks to compare the 18-month weight loss outcomes and complications of the more standard GBP with the newer LDS in a single US center. Methods A retrospective matched cohort was analyzed on 108 patients who had either GBP (54 patients) or LDS (54 patients). Regression analysis was used to compare weight loss outcomes as measured by BMI and weight loss percentages. Complications gathered included bleeds, reoperations, diagnostic or therapeutic endoscopy (EGD), ulcers and chronic nausea. Results GBP and LDS have statistically similar weight loss at 18 months (39.6 vs 41 % weight loss, respectively). However, there were significantly more nausea complaints (26 vs 5), diagnostic endoscopies (EGD) (21 vs 3) and ulcers (6 vs 0) with the GBP than the LDS.
    [Show full text]
  • Biliopancreatic Diversion with a Duodenal Switch
    Obesity Surgeuy, 8, 267-282 Biliopancreatic Diversion with a Duodenal Switch Douglas S. Hess MD, FACS; Douglas W. Hess MD Wood County Hospital, Bowling Green, OH, USA Background: This paper evaluates biliopancreatic BPD without some of the associated problems. diversion combined with the duodenal switch, form- This operation is now used by us for all our ing a hybrid procedure which is a combination of bariatric patients, both in primary surgical proce- restriction and malabsorption. Methods: The evaluation is of the first 440 patients dures and reoperations. undergoing this procedure who had had no previous The difficulty of establishing an operation that bariatric surgery. The mean starting weight was has both long- and short-term success is well 183 kg, with 41% of our patients considered super known. Bariatric surgery is either restrictive or morbidly obese (BMI > 50). malabsorptive in nature, each with its own ad- Results: There was an average maximum weight loss of 80% excess weight by 24 months post- vantages, disadvantages and complications. While operation; this continued at a 70% level for 8 years. trying to find a procedure that would produce Major complications were found in almost 9% of the better long-term results and fewer failures, i.e. cases. There were two perioperative deaths, one regain of weight, we began to look at the from pulmonary embolism and one from acute Scopinaro BPD.l First of all we considered it pulmonary obstruction. There were 36 type II dia- betics, all of whom have discontinued medication only for reoperations on failed restrictive proce- following the surgery.
    [Show full text]
  • Gastroenterostomy and Vagotomy for Chronic Duodenal Ulcer
    Gut, 1969, 10, 366-374 Gut: first published as 10.1136/gut.10.5.366 on 1 May 1969. Downloaded from Gastroenterostomy and vagotomy for chronic duodenal ulcer A. W. DELLIPIANI, I. B. MACLEOD1, J. W. W. THOMSON, AND A. A. SHIVAS From the Departments of Therapeutics, Clinical Surgery, and Pathology, The University ofEdinburgh The number of operative procedures currently in Kingdom answered a postal questionnaire. Eight had vogue in the management of chronic duodenal ulcer died since operation, and three could not be traced. The indicates that none has yet achieved definitive status. patients were questioned particularly with regard to Until recent years, partial gastrectomy was the eating capacity, dumping symptoms, vomiting, ulcer-type dyspepsia, diarrhoea or other change in bowel habit, and favoured operation, but an increasing awareness of a clinical assessment was made based on a modified its significant operative mortality and its metabolic Visick scale. The mean time since operation was 6-9 consequences, along with Dragstedt and Owen's years. demonstration of the effectiveness of vagotomy in Thirty-five patients from this group were admitted to reducing acid secretion (1943), has resulted in the hospital for a full investigation of gastrointestinal and widespread use of vagotomy and gastric drainage. related function two to seven years following their The success of duodenal ulcer surgery cannot be operation. Most were volunteers, but some were selected judged only on low stomal (or recurrent) ulceration because of definite complaints. There were more females rates; the other sequelae of gastric operations must than males (21 females and 14 males). The following be considered.
    [Show full text]
  • Treating Cervical Cancer If You've Been Diagnosed with Cervical Cancer, Your Cancer Care Team Will Talk with You About Treatment Options
    cancer.org | 1.800.227.2345 Treating Cervical Cancer If you've been diagnosed with cervical cancer, your cancer care team will talk with you about treatment options. In choosing your treatment plan, you and your cancer care team will also take into account your age, your overall health, and your personal preferences. How is cervical cancer treated? Common types of treatments for cervical cancer include: ● Surgery for Cervical Cancer ● Radiation Therapy for Cervical Cancer ● Chemotherapy for Cervical Cancer ● Targeted Therapy for Cervical Cancer ● Immunotherapy for Cervical Cancer Common treatment approaches Depending on the type and stage of your cancer, you may need more than one type of treatment. For the earliest stages of cervical cancer, either surgery or radiation combined with chemo may be used. For later stages, radiation combined with chemo is usually the main treatment. Chemo (by itself) is often used to treat advanced cervical cancer. ● Treatment Options for Cervical Cancer, by Stage Who treats cervical cancer? Doctors on your cancer treatment team may include: 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 ● A gynecologist: a doctor who treats diseases of the female reproductive system ● A gynecologic oncologist: a doctor who specializes in cancers of the female reproductive system who can perform surgery and prescribe chemotherapy and other medicines ● A radiation oncologist: a doctor who uses radiation to treat cancer ● A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer Many other specialists may be involved in your care as well, including nurse practitioners, nurses, psychologists, social workers, rehabilitation specialists, and other health professionals.
    [Show full text]
  • A Case Report
    LAPAROSCOPIC POSTERIOR TRUNCAL VAGOTOMY AND ANTERIOR HIGHLY SELECTIVE VAGOTOMY - A CASE REPORT C K Kum, P Goh ABSTRACT Laparoscopie vagotomy provides a viable alternative to expensive long-term treatment with 112 antagonists in patients with intractable peptic ulcer disease. The minimally invasive procedure offers reduced postoperative discomfort and improved cosmesis. Here, we report our first case of a posterior truncal vagotomy and anterior highly selective vagotmny performed laparoscopicallyfor the first time in Asia. The surgery was uneventful. Diet was resumed on day 3 and the patient was discharged on day 4. Post-vagotomy acid secretion tests on the third week revealed a dramatic decrease in acid production. With further experience, laparoscopic vagotomy can be an attractive alternative to long tern medication in peptic ulcer disease. Keywords: Laparoscopy, Vagotomy, Laparoscopic vagotomy, Highly selective vagotomy, Peptic ulcer. SINGAPORE MED J 1992; Vol 33: 302-303 INTRODUCTION ration of the procedure was 150 mins. Postoperatively, the The advent of laparoscopic highly selective vagotomy has pro- patient was able to have feeds on the second day and normal vided patients with ulcer diasthesis a viable alternative to long diet the next day. He was discharged on the fourth day. Acid term dependency on H2 antagonists. Laparoscopic surgery, in secretion tests with insulin stimulation three weeks later re- contrast to conventional open surgery, is characterized by short vealed a dramatic improvement (Table 1). recovery, brief hospitalization and negligible postoperative Operative Procedure scars. We report our first case of laparoscopie highly selective The objective was to denervate the acid -secreting parietal cells vagotomy performed with minimal discomfort to the patient.
    [Show full text]
  • Gender Confirmation Surgery Reference Number: PA.CP.MP.95 Effective Date: 01/18 Coding Implications Last Review Date: 09/17 Revision Log
    Clinical Policy: Gender Confirmation Surgery Reference Number: PA.CP.MP.95 Effective Date: 01/18 Coding Implications Last Review Date: 09/17 Revision Log Description Services for gender confirmation most often include hormone treatment, counseling, psychotherapy, complete hysterectomy, bilateral mastectomy, chest reconstruction or augmentation as appropriate, genital reconstruction, facial hair removal, and certain facial plastic reconstruction. Not every individual will require each intervention so necessity needs to be considered on an individualized basis. This criteria outlines medical necessity criteria for gender confirmation surgery when such services are included under the members’ benefit plan contract provisions. Policy/Criteria It is the policy of Pennsylvania Health and Wellness® (PHW) that the gender confirmation surgeries listed in section III are considered medically necessary for members when diagnosed with gender dysphoria per criteria in section I and when meeting eligibility criteria in section II. I. Gender Dysphoria Criteria, meets A and B A. Marked incongruence between the member’s experienced/expressed gender and assigned gender, of at least 6 month’s duration, as indicated by two or more of the following: 1. Marked incongruence between the member’s experienced/expressed gender and primary and/or secondary sex characteristics; 2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender; 3. A strong desire for the primary and/or secondary sex characteristics of the other gender; 4. A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender); 5. A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender); 6.
    [Show full text]
  • Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010
    Policy Name: Once in a Lifetime Procedures Once in a Lifetime Procedures Code List 2019 Effective: 11/14/2010 Family Rhinectomy Code Description 30160 Rhinectomy; total Family Laryngectomy Code Description 31360 Laryngectomy; total, without radical neck dissection 31365 Laryngectomy; total, with radical neck dissection Family Pneumonectomy Code Description 32440 Removal of lung, pneumonectomy; Removal of lung, pneumonectomy; with resection of segment of trachea followed by 32442 broncho-tracheal anastomosis (sleeve pneumonectomy) 32445 Removal of lung, pneumonectomy; extrapleural Family Splenectomy Code Description 38100 Splenectomy; total (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List 38102 in addition to code for primary procedure) Family Glossectomy Code Description Glossectomy; complete or total, with or without tracheostomy, without radical neck 41140 dissection Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 dissection Family Uvulectomy Code Description 42140 Uvulectomy, excision of uvula Family Gastrectomy Code Description 43620 Gastrectomy, total; with esophagoenterostomy 43621 Gastrectomy, total; with Roux-en-Y reconstruction 43622 Gastrectomy, total; with formation of intestinal pouch, any type Family Colectomy Code Description 44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44155 Colectomy,
    [Show full text]