Digestive system CPT CODING-2017
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Transcript of Digestive system CPT CODING-2017
DIGESTIVE SYSTEM
DIGESTIVE SYSTEM
INTRODUCTION It is also known as alimentary system. The human digestive
system consists of the gastrointestinal tract plus the accessory organs of digestion (the tongue, salivary glands, pancreas, liver, and gallbladder).
DIGESTION The chemical breakdown of complex
biological molecules into their components parts
lipids to fatty acidsproteins to amino acidscarbohydrates to simple sugars
FUNCTIONS OF STOMACH Produces various chemicals to break
down the food Filters out harmful substances Get rid of solid wastes
MECHANICAL ACTION OF DIGESTION
Chew Tear Grind Mash mix
PHASES OF DIGESTION Ingestion Movement Digestion Absorption Further digestion
DIGESTIVE TRACT A long muscular tube with many sections and
areas Starts with mouth ends with anus Parts of digestive tract:
Mouth Pharynx Esophagus Stomach Small intestine Lrge intestine anus
ACCESSORY PARTS
These are not present in digestive tract but helps in digestion of food
teethtonguesalivary glandslivergall bladderpancreas
ENZYMES OF STOMACH PEPSIN: major enzyme converts protiens
into peptides mucus:lubricates food and protects from
strong digestive juices It converts blous into liquid form Chyme after 4 hrs of mechanical and
chemical digestion Chyme passes into small intestine
through sphincter
REMOVAL OF WASTE Two types of wastes 1. Solid waste-from the digestive
system in the form of feces2. Metabolic waste:water, carbon di
oxide, urea,salts
ORGANS OF EXCRETION Skin liver Lungs kidneys
SURGERY OF DIGESTIVE SYSTEM Lips Vestible of mouth Tongue and floor mouth Dentoalveolar structures Palate and uvula Salivary glands and duct Pharynx,adenoids and tonsils
Esophagus Stomach Intestines meckel’s diverticulam and the
mesentry Appendix Colon and rectum
Anus Liver Biliary tract Pancreas Abdomen,peritoneum,and omentum
TYPE OF SURGERIES General surgeries involved in digestive system
are Incision making a cut to drain the fluid Excision partial removal of a tissue Biopsy pathological examination of a removed
tissue Destruction Ablation of a tissue either it may
be benign,premalignant, or malignant tissue by any method with or without curettement(scrapping).
Repair :- after excision the resultant wound is closed by repair
Repair is performed by utilizing sutures, staples, or tissue adhesives(ex,2-cyanoacrylate)
Repair can be done in 3 ways a)Simple repair b)Intermediate repair c)Complex repair
LIPS Vermilionectomy: surgical procedure
used to remove a growth that can form at the border where the lips meet the skin,it is also known as lip shave.
Cheiloplasty: is the technical term for surgery of the lip.in this surgery size of the lip is reduced
Range of code(40490-40799)
VESTIBULE OF MOUTH Frenectomy is the removal of a
frenulum, a small fold of tissue that prevents an organ in the body from moving too far
Frenotomy incision into the frenulum Vestibuloplasty surgical modification of
ginginva Range of code(40800-40899)
TONGUE AND FLOOR OF MOUTH It includes various types of surgery procedures based
upon the type of surgery code range may varies. Glossectomy surgical removal of all or a portion of
the tongue Tracheostomy
creation of an opening into the TRACHEA through the neck
Micrognathia is a condition where abnormal smallness of the jaws, especially the lower jaw.
Frenoplasty surgery of frenum Range of code(41000-41599)
DENTOALVEOLAR STRUCTURES Gingivectomy surgery of gingiva Operculectomy
surgical removal of the operculum, a flap of tissue over a partially erupted tooth.
Alveolectomy surgical excision of part of the alveolar process.
Range of code(41800-41899)
PALATE AND UVULA Major function of this uvula is prevent food from
entering the nasal cavity. Uvulectomy excision of the uvula. Palatopharyngoplasty
a trimming back of excess palatal and pharyngeal tissue, done in order to widen the airway and relieve obstructive sleep apnea or severe snoring.
Palatoplasty surgical reconstruction of the palate Range of code(42000-42299)
SALIVARY GLAND AND DUCT Salivary gland(exocrine gland) which produces saliva. Sialolithotomy excision of a salivary calculus(stone
formation) Marsupialization
conversion of a closed cavity, such as an abscess or cyst into an open pouch, by incising it and suturing the edges of its wall to the edges of the wound.
Sialography study of salivary gland Salivary fistula
any abnormal passage within body tissue, usually between two internal organs.
range of code(42300-42699)
PHARYNX,ADENOIDS AND TONSILS Adenoids are located in nasopharynx. Never assign modifier 50 for surgical
procedures. Tonsillectomy sugery of tonsils Adenoidectomy surgery of adenoids. Range of code(42700-42999)
ESOPHAGUS It is also known as food pipe or gullet
through which food is passed Esophagotomy creation of an artificial
opening into the esophagus. Thoracotomy incision into the pleural
space of the chest Range of code(43020-43135)
ENDOSCOPY It is an instrument used to examine the interior of a
hollow organ or cavity of the body. Unlike most other medical imaging techniques, endoscopes are inserted directly into the organ.
Endoscopy is used to study various organic systems like
a) Gi tract b) Respiratory tractc) Urinory tractd) Reproductive systeme) Laproscopy
ESOPHAGOSCOPY Esophagoscopy includes examination from the cricopharyngeus
muscle(upper esophageal sphincter) to and including the gastroesophageal junction. It may also includes examination of the proximal region of the stomach via retroflexion when performed
Diverticulectomy surgical removal of abnormal pouch of the small intestine
Band ligation is used to treat enlarged veins in the esophagus Snare technique used for surgical extraction and cauterization Esophagus stricture narrowing of esophagus in such conditions
dilation of esophagus is required. Range of code(43180-43233)
ESOPHAGOGASTRODUODENOSCOPY for examination of the cricopharyngeus
muscle(upper esophageal sphincter) to and including the gastroesophageal junction. It may also includes examination of the proximal region of the stomach via retroflexion when performed and finally upto duodenum.
gastrointestinal tract down to the duodenum. If repeat exam is not planned use modifier-52 If repeat exam is planned due to incomplete
evaluation use modifier-53 Range of code(43235-43210)
ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
ERCP is a procedure that enables your physician to examine the pancreatic and bile ducts.
If ERCP is attempted but with unsuccessful cannulation use codes 43235-443259,43266,43270
For percutaneous biliary catheter procedures see 47490-47544
If more than one stent placed during the same session reported with 43274 and modifier 59
Sphincteroplasty reconstruction of anal sphincter
Range of code(43260-43278)
LAPAROSCOPIC FUNDOPLASTY Nissen fundoplication,
or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease(GERD) and hiatal hernia.
Esophagoplasty repair and reconstruction of esophagus
Range of code(43280-43499)
STOMACH Gastrotomy creation of an artificial
opening into the stomach Laprotomy incision into the abdominal
wall Vagotomy surgical removing part of
vagous nerve Range of code(43500-43641)
GASTRIC INTUBATION
is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, past the throat, and down into the stomach
Two types of intubation Orogastric tube(through mouth) Nasogastric tube(through nose) This technique is used to aspire the gastric
contents as well injecting Range of code(43753-43761)
BARIATRIC SURGERY In simple words it is a weight loss
surgery. Weight loss is achieved by reducing the size of the stomach or removal of a portion of the stomach or by resecting and re-routing the small intestine to a small stomach pouch.
It may involve the stomach duodenum,jejunam,and the ileum
Range of code(43770-43846)
MECKEL’S DIVERTICULAM is a slight bulge in the small
intestine present at birth. It is the most common malformation of the gastrointestinal tract.
Range of code(44800-44899)
APPENDIX The is a blind-ended tube connected to
the cecum, from which it develops in the embryo.
Appendicitis is the common condition of appendix
Range of code(44900-44979)
COLON AND RECTUM Proctosigmoidoscopy is the examination of
rectum and may include portion of the sigmoid colon
Sigmoidoscopy examination of the entire rectum,sigmoid colon and may include a portion of the descending colon
Colonoscopy examination of entire colon from the rectum to the cecum and may include terminal ileum or small intestine proximal to an anastomosis
Colonoscopy through stoma examination of the colon from the colostomy stoma to the cecum,and may include terminal ileum or small intestine proximal to an anastomosis.
physician is performing total colonoscopy if the physician is unable to perform to cecum report 45378 with modifier 53.
Range of code(45300-45999)
ANUS Fistulotomy surgical removal of anal fistula Seton Placement A seton (silk string or rubber band) is used to either: Create scar tissue around part of the sphincter
muscle before cutting it with a knife Allow the seton to slowly cut all the way through the
muscle over the course of several weeks The seton may also aid in the drainage of the fistula. Hemorrhoidectomy surgical removal of hemorrhoids Range(46020-46999)
ABDOMEN,PERITONEUM, AND OMENTUM
Hernioplasty surgical operation for the correction of hernia
Herniorrhaphy suture repair of hernia Herniotomy surgical incision of hernia Omentum is a fold of peritonium
connecting the stomach and the abdominal viscera.
Range of code(49000-49999) https://www.medesunglobal.com
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