How To Use CPT Code 44050

CPT 44050 describes the procedure for the reduction of volvulus, intussusception, or internal hernia through a laparotomy. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44050?

CPT 44050 is used to describe a surgical procedure that involves making an incision in the affected part of the intestine to repair twisted, telescoped, or herniated bowel, excluding the rectum. This code is specifically for the reduction of volvulus, intussusception, or internal hernia through a laparotomy.

2. Official Description

The official description of CPT code 44050 is: ‘Reduction of volvulus, intussusception, internal hernia, by laparotomy.’

3. Procedure

1. The provider begins by making an incision in the abdomen to access the target area of the intestine.
2. They carefully divide any adhesions and free the intestine from surrounding organs and tissues.
3. The provider manually reduces the abnormal twisting of the intestine, the telescoping of one segment into another, or the protrusion of an internal organ into the abdominal cavity.
4. After releasing the obstructed segment of bowel, the provider addresses any additional adhesions.
5. They ensure control of bleeding and close the incision with sutures in layers.

4. Qualifying circumstances

CPT 44050 is performed when a patient presents with volvulus, intussusception, or internal hernia that requires surgical reduction through a laparotomy. The procedure is typically performed by a qualified healthcare provider who has the necessary expertise in abdominal surgeries.

5. When to use CPT code 44050

CPT code 44050 should be used when a laparotomy is performed to reduce volvulus, intussusception, or internal hernia. It is important to note that this code does not apply to services on the rectum. If the provider performs correction of malrotation by lysis of duodenal bands or reduction of midgut volvulus, CPT code 44055 should be used instead.

6. Documentation requirements

To support a claim for CPT 44050, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the presence of volvulus, intussusception, or internal hernia
• Details of the laparotomy procedure, including the specific steps taken to reduce the condition
• Date of the procedure
• Any additional findings or procedures performed during the surgery
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 44050, ensure that the procedure meets the criteria for volvulus, intussusception, or internal hernia reduction through a laparotomy. It is important to follow the specific documentation requirements and guidelines set forth by the payer. Additionally, be aware of any bundling or unbundling issues that may affect the billing of this code.

8. Historical information

CPT 44050 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement purposes.

9. Examples

1. A surgeon performs a laparotomy to reduce volvulus in a patient’s small intestine.
2. An emergency physician performs a laparotomy to reduce intussusception in a pediatric patient.
3. A general surgeon performs a laparotomy to reduce an internal hernia in a patient’s abdominal cavity.
4. A colorectal surgeon performs a laparotomy to reduce volvulus in a patient’s large intestine.
5. A pediatric surgeon performs a laparotomy to reduce intussusception in an infant.
6. An abdominal surgeon performs a laparotomy to reduce an internal hernia in a patient with a history of abdominal surgeries.
7. A trauma surgeon performs a laparotomy to reduce volvulus in a patient with a traumatic injury.
8. A gastrointestinal surgeon performs a laparotomy to reduce intussusception in an adult patient.
9. A bariatric surgeon performs a laparotomy to reduce an internal hernia in a patient who has undergone gastric bypass surgery.
10. A surgical oncologist performs a laparotomy to reduce volvulus in a patient with a gastrointestinal tumor.