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Portoenterostomy, commonly referred to as the Kasai procedure, is a surgical intervention primarily aimed at addressing congenital biliary atresia. This condition is characterized by the obstruction or absence of the extrahepatic bile ducts, which are essential for the proper drainage of bile from the liver. When biliary atresia is left untreated, it can lead to severe complications, including cirrhosis and irreversible liver damage. The procedure involves making an incision in the upper midline of the abdomen to access the gallbladder and liver. During the operation, the surgeon meticulously dissects the hilum of the liver to locate the remnant of the biliary tract. The jejunum, a part of the small intestine, is then mobilized and divided to create a Roux-en-Y limb. This limb is crucial as it allows for the anastomosis, or surgical connection, of the distal end of the jejunum to the liver hilum, facilitating bile drainage. The proximal end of the jejunum is also anastomosed to the side of the jejunum, ensuring continuity of the intestinal tract. To manage any potential postoperative complications, drains may be placed as necessary before the abdomen is closed. This procedure is vital for improving bile flow and preventing further liver damage in affected patients.
© Copyright 2025 Coding Ahead. All rights reserved.
The portoenterostomy procedure is indicated for the treatment of congenital biliary atresia, a serious condition that results in the obstruction of bile flow due to the obliteration or discontinuity of the extrahepatic bile ducts. This condition typically presents in infants and, if not addressed, can lead to significant liver damage, including cirrhosis. The procedure aims to restore bile flow and prevent the progression of liver disease.
The portoenterostomy procedure involves several critical steps to ensure successful surgical intervention.
After the portoenterostomy procedure, patients typically require careful monitoring for any complications that may arise. Postoperative care may include managing drains, monitoring liver function, and ensuring proper bile flow. Recovery time can vary, and follow-up appointments are essential to assess the success of the procedure and the patient's overall health. It is crucial to provide supportive care and education to the family regarding signs of complications and the importance of ongoing medical follow-up.
| Short Descr | BILE DUCT REVISION | Medium Descr | PORTOENETEROSTOMY | Long Descr | Portoenterostomy (eg, Kasai procedure) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 99 - Other OR gastrointestinal therapeutic procedures |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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