How To Use CPT Code 44137

CPT 44137 describes the complete removal of a transplanted intestinal allograft from a patient. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44137?

CPT 44137 can be used to describe the complete removal of a transplanted intestinal allograft from a patient. This code is used when the provider identifies and removes the graft from the upper and lower anastomotic sites, dissects the blood vessels, and connects the ends of the bowel segments together or to a stoma. The most common reason for removal is rejection of the graft.

2. Official Description

The official description of CPT code 44137 is the “Removal of transplanted intestinal allograft, complete.” This code is used when the provider completely removes a small intestine graft from a patient. It is important to note that for partial removal of a transplant allograft, different codes should be used (44120, 44121, 44140).

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. A midline abdominal incision is made from the xiphoid to the pubis.
3. The provider identifies and inspects the small intestine graft.
4. The graft is removed from the upper and lower anastomotic sites.
5. The blood vessels are dissected.
6. The ends of the bowel segments are connected together or to a stoma.
7. The lower end is sutured closed.
8. The procedure is completed, and the incision is closed.

4. Qualifying circumstances

CPT 44137 is performed when a patient has a transplanted intestinal allograft that needs to be completely removed. The provider must identify and inspect the graft, remove it from the upper and lower anastomotic sites, and dissect the blood vessels. The procedure may involve connecting the ends of the bowel segments together or to a stoma, and suturing the lower end closed. The most common reason for performing this procedure is the rejection of the graft.

5. When to use CPT code 44137

CPT code 44137 should be used when a provider needs to completely remove a transplanted intestinal allograft from a patient. It is important to ensure that the procedure involves the removal of the entire graft and not just a partial removal. If a partial removal is performed, different codes should be used (44120, 44121, 44140).

6. Documentation requirements

To support a claim for CPT 44137, the provider must document the following information:

• Patient’s medical history and indication for the removal of the transplanted intestinal allograft
• Details of the procedure, including the incision site, identification and removal of the graft, dissection of blood vessels, and connection of bowel segments
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 44137, ensure that the procedure involves the complete removal of a transplanted intestinal allograft. It is important to use the appropriate code for partial removal (44120, 44121, 44140) if applicable. There are no specific guidelines regarding reporting CPT 44137 with other codes, but it is important to accurately document and code all services provided during the procedure.

8. Historical information

CPT 44137 was added to the Current Procedural Terminology system on January 1, 2005. The code has not undergone any updates since its addition. It is worth noting that Medicare added CPT 44137 to the Inpatient Only (IPO) list in 2017.

9. Examples

1. A patient undergoes a complete removal of a transplanted intestinal allograft due to graft rejection.
2. A provider performs a complete removal of a transplanted intestinal allograft after identifying complications during the post-transplant period.
3. A patient requires a complete removal of a transplanted intestinal allograft due to infection at the graft site.
4. A provider performs a complete removal of a transplanted intestinal allograft to address chronic rejection and improve the patient’s overall health.
5. A patient undergoes a complete removal of a transplanted intestinal allograft as part of a multi-organ transplant revision procedure.
6. A provider performs a complete removal of a transplanted intestinal allograft to address complications related to the anastomosis.
7. A patient requires a complete removal of a transplanted intestinal allograft due to the development of a new medical condition that contraindicates the presence of the graft.
8. A provider performs a complete removal of a transplanted intestinal allograft to address recurrent infections and improve the patient’s quality of life.
9. A patient undergoes a complete removal of a transplanted intestinal allograft after experiencing severe graft-versus-host disease.
10. A provider performs a complete removal of a transplanted intestinal allograft to address chronic ischemia and restore proper blood flow to the intestines.