Complicated Gastrostomy

Ok... so here's a mess:

A patient once had a gastrostomy. This gastrostomy had a "complication" that caused the contents to spill into her peritoneal cavity, causing septic shock.

At Hospital A, she had extensive surgery to have the gastroscopy removed and the surrounding area repaired.

At Hospital B, she was treated for Critical Illness Myopathy and had a EGD performed to find gastritis.

According to the nurse, she is caring for the abdominal wound from Hospital A. At this point, I don't know how to code it. When recovering from other complications, one would normally code the complication with the letter "D" to capture recovery. Being that the code for a "Gastrostomy Complication" is 'K94.23' - I don't have that option.

Do I capture the abdominal wound with "Aftercare following digestive surgery"??


  • Added note: I know that we usually code "Z43.1" to care for the abdominal wound following a gastrostomy takedown, because it's considered an ostomy site until the site is completely healed according to guidelines - but my nursing coordinator disagrees that it is still considered an "ostomy site" because of the manner in which she needed "extensive surgery". Input?
  • I agree with you - the gastrostomy complication was resolved with surgery and it becomes a surgical wound on OASIS. You're left coding aftercare GI. You'll capture the complication in M1011/M1017 if the dates work.

    Lisa Sharpe, HCS-D
    Coding Specialist
    Sanford Bemidji HomeCare and Hospice
    3201 Pine Ridge Ave NW RT# 10800
    Bemidji MN 56601
    Phone 218-333-5764  Fax 218-333-6017
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