27 Oct Disorders of the Digestive System

Disorders of the Digestive System 5.13. The following documentation is from the health record of a female patient. Outpatient Operative Report This patient with hiatal hernia is admitted to same-day surgery for repair. Description of Procedure: The patient was placed under satisfactory general endo. tracheal anesthesia. She was then placed in the lithotomy position. Foley was placed Orogastric tube was inserted. The abdomen was prepped and draped in normal sterile fashion. A supraumbilical incision was made to the midline, and the fascia was incised to enter the abdomen. Under direct visualization, a 0 Vicryl stitch was placed on each side of the fascia, and a blunt Hasson trocar was inserted. The abdomen was insufflated with CO2. Under direct visualization, two 11-mm ports were placed in the left subcostal region, and 11-mm and 12-mm ports were placed in the right subcostal region. The liver bed was then lifted up off the gastrohepatic ligament. The gastrohepatic ligament was taken down with harmonic scalpel. The right crus of the diaphragm was identified and dissected out with harmonic scalpel and blunt dissection. I dissected out the phrenicoesophageal ligament anteriorly and came around identifying the left crus. I then took down the short gastrics from the midportion of the greater curvature of the stomach up to the GE junction, using harmonic scalpel and taking care to not damage the spleen. Once we had adequately taken down the short gastrics, the pos- terior ligament was then mobilized behind the esophagus, and the stomach easily pulled through with no tension and no twist on the esophagus and easily laid in place. The hiatal hernia was then repaired with a posterior cruropexy stitch of 0 ETHIBOND. The wrap was then brought around and was placed approximately 2 cm into the esophagus with a horizontal mattress pledgeted 0 ETHIBOND stitch. A second interrupted stitch was placed just through-and-through on the stomach below this. At the end of the procedure, there was no tension or twist on the esophagus and no bleeding apparent. All ports were removed under direct visualization and there appeared to be hemostasis. The fascia at the supraumbilical incision was closed with 0 Vicryl. The skin was anesthetized with local anesthetic and then closed with 4-0 subcuticular MONOCRYL. Which ICD-10-CM and CPT codes are reported for this case? a. K44.9, 43327 b. K44.9, 43280 C. K44.0, 43280 d. K44.9, 43328