How To Use CPT Code 44055

CPT 44055 describes the correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus, also known as the Ladd procedure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44055?

CPT 44055 is used to describe the correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus, specifically through the Ladd procedure. This code is utilized when the provider makes an incision to reach the affected part of the intestine, alleviating and derotating the intestinal malrotation by reducing or destroying bands of tissue that are kinking the duodenum.

2. Official Description

The official description of CPT code 44055 is: ‘Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd procedure).’ It is important to note that modifier 63 should not be reported in conjunction with this code.

3. Procedure

1. When performing CPT 44055, the provider begins by making an abdominal incision to access the affected area of the intestine.
2. They then explore the presence and degree of volvulus in the intestine, assessing the severity of the condition.
3. If midgut volvulus is present, the provider manually straightens the malrotated bowel without the need for resection.
4. If duodenal bands are present, the provider mobilizes the duodenum and dissects the adhesions that are coursing over it.
5. The provider may use reduction, lysis, or both techniques to correct the malrotation and alleviate the volvulus.
6. After completing the procedure, the provider irrigates the cavity and ensures control of bleeding.
7. Finally, they close the incision with sutures in layers to promote proper healing.

4. Qualifying circumstances

CPT 44055 is performed on patients with malrotation, a condition where the intestines are not properly positioned in the abdomen. This procedure is specifically used to correct malrotation by lysis of duodenal bands and/or reduction of midgut volvulus. It is important to note that modifier 63 should not be reported with this code.

5. When to use CPT code 44055

CPT code 44055 should be used when the provider is performing the Ladd procedure to correct malrotation by lysis of duodenal bands and/or reduction of midgut volvulus. It is important to ensure that the procedure aligns with the specific description of this code and that modifier 63 is not used.

6. Documentation requirements

To support a claim for CPT 44055, the provider must document the following information:

• Patient’s diagnosis of malrotation
• Details of the procedure performed, including lysis of duodenal bands and/or reduction of midgut volvulus
• Incision site and approach used
• Any additional procedures performed during the same operative session
• Any complications encountered and their management
• Postoperative care instructions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 44055, ensure that the procedure aligns with the specific description of the code and that modifier 63 is not used. It is important to follow the appropriate coding guidelines and documentation requirements to support the claim. Additionally, consider any specific billing guidelines provided by payers or insurance companies.

8. Historical information

CPT code 44055 was added to the Current Procedural Terminology system on January 1, 1990. It is important to note that in 2017, it was added under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs CPT 44055 on a pediatric patient with malrotation, correcting the condition by lysis of duodenal bands and reduction of midgut volvulus.
2. During a surgical procedure, the provider utilizes CPT 44055 to correct malrotation in an adult patient, performing the Ladd procedure.
3. A patient presents with symptoms of intestinal malrotation, and the provider performs CPT 44055 to alleviate the condition and restore proper intestinal positioning.
4. Using CPT 44055, the provider corrects midgut volvulus in an infant, performing the necessary lysis of duodenal bands and reduction of the volvulus.
5. A provider performs the Ladd procedure using CPT 44055 to correct malrotation in a teenage patient, ensuring proper alignment of the intestines.
6. During a surgical intervention, the provider utilizes CPT 44055 to address malrotation in a geriatric patient, performing the necessary lysis of duodenal bands and reduction of the volvulus.
7. A pediatric patient undergoes CPT 44055 to correct malrotation, with the provider successfully performing the Ladd procedure.
8. Using CPT 44055, the provider corrects midgut volvulus in an adult patient, ensuring proper alignment of the intestines and alleviating symptoms.
9. A provider performs the Ladd procedure using CPT 44055 to address malrotation in an adolescent patient, restoring proper intestinal positioning.
10. During a surgical intervention, the provider utilizes CPT 44055 to correct malrotation in a young adult patient, performing the necessary lysis of duodenal bands and reduction of the volvulus.