altemeier procedure pcs code

Br J Surg. The step-by-step outline above should give you an idea of what to expect should you require this surgical procedure. Senapati A, Gray RG, Middleton LJ, et al. 2004;91:150024. Treatment of rectal prolapse. 2015;29(3):60713. Epub 2019 Nov 13. That being said, there is evidence that there is a recurrence rate following the procedure and the operation is considered unpredictable regarding the restoration of continence. The amount of time you spend in the hospital, possibly just overnight, will depend on which procedure you have. Before Consensus Statement of the Italian Society of Colorectal Surgery (SICCR): management and treatment of complete rectal prolapse. If you have rectal prolapse and certain other conditions, such as vaginal prolapse or pelvic organ prolapse, you might have both repairs done in one surgery. Reissman P, Weiss E, Teoh TA, Cohen SM, Wexner SD. Epub 2019 Nov 13. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 2006 May;49(5):652-60. doi: 10.1007/s10350-006-0505-6. Specific Documentation Needed for Accurate Coding. Faucheron JL, Voirin D, Riboud R, et al. In this article, we will take a closer look at what a rectal prolapse is, and go through the Altemeier procedure step-by-step so that you will become familiar with what to expect from this operation. Rectal procidentia in elderly and debilitated patients. There was no post-operative mortality at 30days. Outcome of laparoscopic rectopexy versus perineal rectosigmoidectomy for full-thickness rectal prolapse in elderly patients. Dis Colon Rectum. Antonio e Biagio e Cesare Arrigo-Alessandria, Italy and is in accordance with the Declaration of Helsinki. Iran Red Crescent Med J. Surgical Procedures on the Colon and Rectum. The .gov means its official. Madiba TE, Baig MK, Wexner SD. coding and reporting using the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS). Results: The 2020 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2020. The condition is not considered life-threatening, but the symptoms can be debilitating if left unchecked. Alwahid M, Knight SR, Wadhawan H, Campbell KL, Ziyaie D, Koch SMP. There are currently few defined preoperative factors in patients presenting with rectal prolapse and fecal leakage which predict for the restoration of continence after surgery. Or is there a seperate code for the levatorplasty code that I can bill in addition to the 45130 code.  Fr&@I p6; a|=aj GLeh}H,\J+IhM)fJkM6=cpwMgw{ME4jpIr{`lj/zbv\Oi>"z. There was statistically significant differences in the ODS score changes between the 21 patients who underwent a levatorplasty and the 13 who did not with a median of differences of 0 in the group without plasty and of 2 in the group with plasty (p=0.0156) while there were no differences in Vaizey score changes (p=0.4524). Many comparisons of the perineal and abdominal approaches have pointed to worsening or the de novo appearance of obstructed defecation in the case of the latter [19]. 2005;94(3):20710. is entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and/or any other body layers necessary to reach the site of the procedure. Each female had had a mean of 1.4 deliveries. External, For the past 30 years, HIA has been the leading provider of, , physician groups and other healthcare entities. Murad-Regadas SM, Pinto RA. All authors gave their final approval of the version to be published and are co-authors of the present paper. The relatively high number of recurrences after perineal repair should be balanced with the minimal invasiveness of the technique and the possibility of repeat it with no additional morbidity and considering the relatively long recurrence time. Fleming et al. She says she has pain and rectal bleeding. [?mgf|uH or Alcoholism and Psychiatric Disorders: How Can They Be Treated? Despite the finding of a higher satisfaction in all patients it is not surprising that this was largely due to the benefit perceived by the patients not developing recurrences. Long term follow-up was performed in 34 available patients with three patients lost to follow up and six deceased for reasons related to their ages and comorbidity not related to the surgical procedure (they would have had at the time of long term follow-up an average age of 90years old with a median of 91years old) being excluded from the analysis. Tech Coloproctol. Nineteen years experience with the one-stage perineal repair of rectal prolapse. Data on follow-up and recurrences. 2021 ICD-10-PCS | CMS - Centers For Medicare & Medicaid Services External rectal prolapse: abdominal or perineal repair for men? Twenty-eight (65%) patients had a previous history of cardiovascular disease, 13 (30%) a neurological or psychiatric disorder, and 30 (70%) had had previous pelvic surgery. The colon carries waste to be expelled from the body. The ICIQ SF score showed that urinary incontinence improved in one patient, worsened in five, and in 28 there was no change with a median pre-operative ICIQ SF score of 0 and no difference postoperatively (p=0.062). These 2021 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021. Advances in preoperative risk assessment and management. The Altemeier repair: outpatient treatment of rectal prolapse. Surg Endosc. 2023 BioMed Central Ltd unless otherwise stated. ?y3\EB:~7+PV]z'.6GB^#H8|KUT/.c_\JfKw11Z The score on patients satisfaction and the urinary retention score are not validated. Prospective study in 54 consecutive patients. uLj/nHFtGi=OijL9N2Jwh[27gXA{8H@j.aHMdJ,348aJ^Lhx=8Yet49/HD6*D>n@Z{{K5#H&5TqrB8H.GhXCvFq((X 7 The relationship between changes in the ODS score and Vaizey score in respect to levatorplasty was evaluated using the unpaired t-test and the Mann-Whitney U-test. Once the external prolapse has complete exposure, the Lone Star retractor is attached. 2023 ICD-10-PCS Procedure Code - ICD10Data 2006;30:65963. At the same follow-up there were 12 (35%) cases of recurrence with an estimated risk at 48months of 40%. Transanal rectopexy for external rectal prolapse. Surgical Approaches - Open vs. Percutaneous vs. ICD-10-PCS Code Lookup, ICD 10 Procedure Codes - AAPC When applying the sutures, there is a requirement for a full-thickness stitch that runs from the submucosa to the inside and then the return stitch from the inside to the outside. Data on perioperative management including bowel preparation, antibiotic and thromboembolic prophylaxis, and type of anesthesia were also collected. <>/Metadata 4156 0 R/ViewerPreferences 4157 0 R>> The mean time for the operation was 97.7 minutes (range, 50-180 min) with a mean 7.2 cm of rectum resected (range, 2.5-26.7 cm). The site is secure. Post-operative complications at 30days occurred in 18 patients (38%). 2004;240(2):20513. 2023 ICD-10-PCS Procedure Code 0DTP0ZZ Resection of Rectum, Open Approach 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code ICD-10-PCS 0DTP0ZZ is a specific/billable code that can be used to indicate a procedure. 2019 Nov;23(11):1065-1072. doi: 10.1007/s10151-019-02100-z. 2022 Dec;38(6):415-422. doi: 10.3393/ac.2021.00262.0037. Tamanini JTN, Dambros M, DAncona CAL, et al. Pre and post-operative functional scores and data above recurrences and time to recurrences collected from each patient. You'll spend a brief time in the hospital recovering and regaining your bowel function. Potential Risks Bleeding or hematoma development requiring reoperation. Dear Editor. Fortunately, there is a procedure that can correct the condition. The 2021 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2021. 2023 ICD-10-PCS Procedure Code - ICD10Data.com Hoel AT, Skarstein A, Ovrebo KK. 30days morbidity according to Clavien-Dindo classification [4] and 30days mortality were recorded. Percutaneous endoscopic-assisted procedures are coded to the open approach as stated above. How Monitoring Your HRV Can Help You Keep Track of Your Overall Health with Welltory, 8 Common Practices That Actually Cause Damage To Your Oral Health, Travel Nursing Skills: 6 Skills & Qualities, No, I Dont Want To Receive Healthcare Breaking News Reports. Marzouk D, Ramdass MJ, Haji A, et al. All patients received a complete bowel preparation, antibiotic prophylaxis (Cefazolin and Metronidazole) and thromboembolic prophylaxis (low-molecular-weight heparin). Note: There is no GEMs file. 45126. Urinary function was determined pre and post-operatively using the validated International Consultation on Incontinence Questionnaire Short Form (ICIQ SF) score (range 0 [normal]-21) and a pre and post-operative evaluation of the residual urinary volume was made by a four-degree severity score (0 for <50mL, 1 for >50<100mL, 2 for >100<200mL, 3 for >200ml) [7, 8]. They found that a perineal approach was independently associated with a lower 30-day major and minor complication rate than any abdominal procedure. [5]. Surg Radiol Anat. In Table 4 are summarized the literature data on recurrences after Altemeiers procedure [10,11,12,13,14,15,16,17,18, 24,25,26,27,28,29,30]. Epub 2018 Dec 15. Another method for repairing a rectal prolapse through the perineum (Delorme procedure) is more typically done for short prolapses. Please enable it to take advantage of the complete set of features! 2019 Jan;23(1):1-2. doi: 10.1007/s10151-019-01937-8. The 2023 ICD-10-PCS is the latest code set revision and is valid for . CPT Codes. UdA|gV?jB(rWPARO K;&EI)E}Ck)o "8&u\4;?@ There is no GEMs file. Female gender with possible obstetric trauma, the wider pelvis and weaker pelvic floor due to age and gender are factors that would contribute to poor function and the failure of repair of the prolapse to alter most of the functional scores indicates that the prolapse itself may not be an important factor in the bowel and urinary dysfunction often observed in patients with prolapse. 2016;27(1):339. D'\=> Major complications were not related to the ASA score, BMI or age [average age 76.4]. (Additionalfile1). The procedure is known as the Altemeier perineal rectosigmoidectomy. There was no statistically significant difference in the Vaizey score before and after surgery (p=1.000) (Fig. Practice guidelines recommend perineal rectosigmoidectomy (Altemeier procedure) for rectal prolapse greater than 5 cm 1.However, anastomotic complications are a cause for concern as they can be as common as one in three cases 2-4.In this multicentre retrospective study, 318 patients from 10 hospitals (from 2010 to 2021) were analysed. PMID: 33458932 is for procedures performed directly on the skin or mucous membrane and procedures performed indirectly by the application of external force through the skin or mucous membrane. Free 2023 ICD-10-PCS Procedure Codes - ICD10Data.com The attempt to improve function is based on the assumption that the restoration of the anatomy will lead to relief of disturbances of function [22]. 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-PCS) Which approach your surgeon uses depends on a number of factors, such as the size of your prolapse, your age, other health problems, your surgeon's experience and preferences, and equipment available. Curr Probl Surg. It is important to note that rectal prolapse does not always occur with symptoms. National Library of Medicine Your doctor is likely to recommend drinking lots of fluids, using stool softeners, and eating a fiber-rich diet in the weeks after surgery to avoid constipation and excessive straining that can lead to recurrence of the rectal prolapse. The probability of recurrence at 48months was determined using the Kaplan-Meier method. Discuss your options with your surgeon. A laparoscopic approach to rectal prolapse repair has become increasingly popular. 2005;140(1):6373. Laparoscopic-assisted perineal rectosigmoidectomy for rectal prolapse. Williams JG, Rothenberger DA, Madoff RD, et al. The Altemeier procedure for rectal prolapse provided excellent results across all age groups with minimal morbidity, allowing for short hospital stays and periods of convalescence. The authors declare that they have no competing interests. Post-operative complications at 30days occurred in 18 patients (38%): these were classified as Clavien-Dindo grade 1 in 14 patients (78%), grade 2 in 3 patients (17%), grade 3 in zero, and grade 4 in only one patient (5%). ICD-10-PCS 0WQNXZZ is intended for females as it is clinically and virtually impossible to be applicable to a male. How to do an Altemeier perineal rectosigmoidectomy for full - PubMed An official website of the United States government. This would be coded as an open approach since the laceration has cut through the external body layers exposing the muscle. A p-value of <0.05 was considered to be statistically significant. The present study evaluated the morbidity, mortality, function and recurrence rate in patients undergoing Altemeiers operation for complete rectal prolapse. Using digital means, the lateral ligaments experience transection with their pathways running between the ligatures. It appears to be slightly more common in people who have the perineal procedure compared with an abdominal one. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. 2015;19(9):5215. Ramanujam PS, Venkatesh KS, Fietz MJ. However, in some cases, constipation can worsen or become a problem when it wasn't one before surgery. Google Scholar. The CMS ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. A single copy of these materials may be reprinted for noncommercial personal use only. The mean length of hospital stay was 6 [38] days. Elagili F, Gurland B, Liu X, et al. Your surgeon will suggest the appropriate one for you based on your condition and your overall health. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 576 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> All rights reserved. Martnez Hernndez-Magro P, Villanueva Senz E, Sandoval Munro RD. Day case robotic ventral rectopexy compared with day case laparoscopic ventral rectopexy: a prospective study. Arch Surg. Of these 30, 14 had had a previous surgical repair for rectal prolapse by various techniques (4 Delorme, 2 STARR, 1 transanal proctopexy, 1 rectosigmoidectomy + anal encirclement, 1 rectopexy, 1 rectopexy with mesh, 1 Wells procedure, 3 no data), 24 had had a hysterectomy and seven had had a cystopexy. 2004;8(1):39. Thirty four patients were assessed at a median interval of 49 (2135) months, six being deceased for reason not related to the prolapse and three lost to follow-up. Epub 2019 May 9. The average duration of symptoms was 2years. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government. For most people, rectal prolapse surgery relieves symptoms and improves fecal incontinence and constipation. PDF 2023 Coding & Payment Quick Reference - Boston Scientific There is no GEMs file. There were no statistically significant differences between patients with and without recurrence regarding age (p=0.188), BMI (p=0.864), ASA score (p=0.433), recurrent prolapse (p=0.398), previous hysterectomy (p=0.705), length of resected bowel (p=0.126), and levatorplasty (p=0.304) (Table2). 4 0 obj ,Lm-Y6+k715AK.66c-')>9Vc Wy#Wp}0s. Color Dis. When the walls of the rectum displace enough so that they extend out of the anus and are easy to see outside of the body, this is what is known as rectal prolapse. The procedure has a high success rate. Preoperative constipation (61% of patients) improved in 94% and preoperative fecal incontinence (47% of patients) improved in 85%, whereas 15% developed new onset of seepage or incontinence to flatus. When reporting procedures on this list, facilities should capture both the CPT1 code representing the procedure performed and the . Altemeier | definition of Altemeier by Medical dictionary Xynos E. Functional results after surgery for overt rectal prolaps. These 2021 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021. 1). Surgical treatments proposed are divided in abdominal and perineal procedures. hbspt.cta._relativeUrls=true;hbspt.cta.load(20824215, '2b82b46d-7aa0-44a0-9e8c-d8ba62294969', {"useNewLoader":"true","region":"na1"}); The information contained in this coding advice is valid at the time of posting. Lung Transplantation Services at UW Medical Center - Montlake. Note: There is no GEMs file. [Surgical options in the treatment of rectal prolapse: indications, techniques and results]. 2023 Coding & Payment Quick Reference Select Enteral Feeding Procedures Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding or site of service requirements. (Additional file 1). This repair is typically reserved for those who are not candidates for open or laparoscopic repair. Share sensitive information only on official, secure websites. Carditello A, Milone A, Stilo F, Mollo F, Basile M. Zentralbl Chir. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Color Dis. Lee SH, Lakhtaria P, Canedo J, et al. Dis Colon Rectum. Excision Procedures on the Rectum. 1995 Jun;5(3):217-8. I prefer the 45130 code as this says "excision of rectal procidentia." It doesn't necessarily mean proctectomy..If you excise the mucosa as in a Delorme, this is an excision of the procidentia in my opinion. This is done with an optional anterior levatorplasty. It is also associated with a mixed pattern of functional disorders ranging from difficulty of evacuation of stool, so called obstructive defecation syndrome (ODS), to fecal incontinence. The aim of surgical repair is to reduce the mobility of the rectum and sigmoid colon by fixation with or without removal of the prolapsing rectum and sigmoid colon and to give mechanical support to sphincters and pelvic floor [3]. Breaking industry news, startup innovation alerts & emerging HealthTech News. This content does not have an English version. Continence was assessed pre and post-operatively using the Vaizey scoring system [6], which ranges from 0 (normal continence) to 24 (severe incontinence). M\E-"S0@/RL*b\Dw!Vc#'/fp(XV=r- #yOq|dxW[%u!fU" *tE>I%`kx{x"G'|J! The sigmoid receives transection at a level where there is a stretch in the colon. An announcement was also made at the September 2017 ICD-10 Coordination and Maintenance Committee meeting that FY 2018 would be the last GEMs file update. Arch Surg. How to do an Altemeier perineal rectosigmoidectomy for full-thickness rectal prolapse Authors Shinichiro Sakata 1 , Nicholas P McKenna 1 , Ahmed Allawi 1 , Anne-Lise D D'Angelo 1 , Heidi K Chua 1 , Eric J Dozois 1 Affiliation 1 Department of Surgery, Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA. Nat Clin Pract Gastroenterol Hepatol. of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy, Department of Biostatistics, S.Gaudenzio Clinic, Policlinico di Monza, Italy, Department of General Surgery, University of Catanzaro, Catanzaro, Italy, You can also search for this author in Altemeiers procedure for complete rectal prolapse; outcome and function in 43 consecutive female patients, https://doi.org/10.1186/s12893-018-0463-7, https://doi.org/10.1002/14651858.CD001758.pub3, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Interestingly, levatorplasty offered an improvement in the ODS score while hadnt any discernable effect on Vaizey score. Acta Chir Iugosl. Here is a breakdown of the seven major steps commonly followed in the treatment of rectal prolapse. Rectal prolapse surgery requires anesthesia. 0 Medical and Surgical 1 Obstetrics 2 Placement 3 Administration 4 Measurement and Monitoring 5 Extracorporeal or Systemic Assistance and Performance 6 Extracorporeal or Systemic Therapies As the transection is performed, the lumen should be opened step-by-step from 12 oclock. The relatively high number of recurrences should be balanced with the minimal invasiveness of the technique and the possibility of repeating it with no additional morbidity and considering the relatively long recurrence time that in our cases was 17months in mean with no deterioration in function. Data on 43 consecutive female patients undergoing Altemeiers procedure for complete rectal prolapse were reviewed. In contrast to the many observational studies, the PROSPER randomized study, the largest on rectal prolapse, compared the recurrence rate, incontinence, bowel function and quality of life (QoL) of perineal and abdominal procedures and showed an improvement in symptom-specific and overall QoL for both types of procedure with a similar incidence of recurrence (28% vs 19%; p=0.2) and no significant difference in bowel function and QoL [15]. https://www.uptodate.com/contents/search. 2010;53(12):161823. Altomare DF, Di Lena M, Giuratrabocchetta S, et al. The dentate line is a crucial element as a circular incision goes in the outer duplication of the rectal wall roughly one or two centimeters above the dentate line. Comparing perineal repairs for rectal prolapse: Delorme versus Altemeier. Auguste T, Dubreuil A, Bost R, et al. Make a donation. Unauthorized use of these marks is strictly prohibited. Examples include knee arthroscopy and laparoscopic cholecystectomy. There was no mortality, minimal morbidity (14%), and no recurrence. Altemeiers procedure had in our series low complications rate and no mortality. The Mann-Whitney U-Test was used to evaluate patient satisfaction regarding recurrence. Fecal incontinence improved in 11 patients, worsened in 10 and was unchanged in 13. https://doi.org/10.1002/14651858.CD001758.pub3. The coding professional must be able to identify all procedural elements to correctly assign all seven characters of the ICD-10-PCS code. As for recurrence, the most logical treatment is a second Altemeier procedure. Only two patients who presented with rectal prolapse recurrence underwent a reoperation, one redo-Altemeiers procedure and one Goldbergs procedure. The patients were identified by the diagnostic code on admission of International Classification of Diseases (ICD)-9: 569.1 and by the surgical code ICD-9: 4849. William A. Altemeier M.D. | UW Medicine Code History. evaluated the perioperative outcome of patients with complete rectal prolapse from the American College of Surgeon National Surgical Quality Improvement Program (NSQIP) to determine the safety of different surgical approaches. Official websites use .govA Chun SW, Pikarsky AJ, You SY, et al. Join 50,000 healthcare professionals and get our weekly newsletter delivered to your inbox. The problem is most common in older women, but it can also occur in men. 8600 Rockville Pike website belongs to an official government organization in the United States. The relationship between recurrence and age, BMI, previous rectal prolapse surgery, previous hysterectomy, levatorplasty, length of resected bowel and gender was evaluated using an independent-sample t-test, Pearsons chi-squared test or Fishers exact test. The 2021 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2021. You also have the option to opt-out of these cookies. Coding Root Operations with ICD-10-PCS: Understanding Drainage - AHIMA Rev Gastroenterol Mex. PDF Surgery Codes Rectum - Surveillance, Epidemiology, And End Results Article The suture line receives inspection with a speculum and an easy-flow drain goes in the anal canal. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 3 0 obj These cookies do not store any personal information. Rev Saude Publica. Patient satisfaction showed a mean of 8.8 and 6.4 respectively in patients without and with recurrences (p=0.012). 1994;37(10):102730. They include rectal bleeding, symptoms of obstructed defecation, mucous discharge from the anus, and degrees of fecal incontinence. The https:// ensures that you are connecting to the These cookies will be stored in your browser only with your consent. Digital assessment of lower rectum fixity in rectal prolapse (DALR): a simple clinical anatomical test to determine the most suitable approach (abdominal versus perineal) for repair. Few publications reported data on the effect of Altemeiers operation on function and those show different results among the series; data are summarized in Table 3 [10,11,12,13,14,15,16,17,18]. Statistical analysis: Descriptive data are presented as parametric data and non-parametric data. PubMedGoogle Scholar. Google Scholar. 2012 Jun;55(6):666-70. doi: 10.1097/DCR.0b013e31825042c5. Experience with the one-stage perineal repair of rectal prolapse. who reported a statistically significant association of revision Altemeier procedure with recurrence or to the report of Kim et al. These 2020 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2019 through September 30, 2020. 2001;44(4):56570. Rectal prolapse surgery carries serious risks. 2012 Sep;14(9):1106-11. doi: 10.1111/j.1463-1318.2011.02904.x. Inpatient medical coders and billers rely on the ICD-10-PCS, which is distinct from ICD-10-CM. Your answer will greatly help. HHS Vulnerability Disclosure, Help Dis Colon Rectum. The Altemeiers procedure is an available low risk treatment that can be performed under regional anesthesia, recovery is rapid and it gives immediate relief of the prolapse itself. Google Scholar. On the specimen, the Douglas pouch will be obvious and maybe up to half a meter in length with the rectum measuring only about five centimeters. An official website of the United States government This site needs JavaScript to work properly. Moreover, a recent Cochrane review failed to confirm the superiority of transabdominal over perineal procedures, due to the heterogeneity and poor quality of the available studies [31]. ICD-10-PCS Procedure Codes - 2023 Complete Reference Art. https:// These findings support the results obtained in the present study which included a rate of major complications of 2.3% (one patient), which were not related to the ASA score, BMI or age, and no 30days mortality. The files in the Downloads section below contain information on the ICD-10-PCS COVID-19 updates effective with discharges on and after August 1, 2020. Surgical Procedures on the Digestive System. According to many researchers, there are between three and five ways in which the rectal prolapse can occur. There was no post-operative mortality at 30days. Varma MG, et al. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates. There are also multiple examples in the ICD-10-PCS Reference Manual to help you better understand the procedure approaches. hZeW Unauthorized use of these marks is strictly prohibited. Department of Colorectal Surgery. Altemeier Procedure for Full-thickness Rectal Prolapse Complicated by Ischemic Stricture - YouTube This edited video shows the performance of an Altemeier Procedure for a patient with.