How To Use CPT Code 44144

CPT 44144 describes a surgical procedure known as partial colectomy with resection, colostomy or ileostomy, and creation of a mucous fistula. This article will provide an overview of the code, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44144?

CPT 44144 is used to describe a surgical procedure called partial colectomy with resection, colostomy or ileostomy, and creation of a mucous fistula. This code is used when a provider removes a portion of the colon, brings the upper and lower ends of the colon through separate incisions on the skin of the abdomen, and creates a colostomy or ileostomy for the expulsion of fecal matter. Additionally, a mucous fistula is created to allow the removal of mucus from the disconnected lower end of the bowel.

2. Official Description

The official description of CPT code 44144 is: ‘Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula.’

3. Procedure

1. During the procedure, the provider makes an incision in the abdomen to access the colon.
2. The affected portion of the colon, along with the blood vessels and lymph nodes, is identified and removed.
3. The upper end of the colon is brought up to the skin level of the abdomen and sewn to the skin through a separate incision, creating a colostomy or ileostomy.
4. The lower end of the colon is also brought up to the skin level of the abdomen and sewn to the skin through a separate incision, creating a mucous fistula.
5. The provider ensures there is no bleeding, removes any instruments, and closes the incision in the abdomen used for the colectomy.

4. Qualifying circumstances

CPT 44144 is typically performed on patients with colorectal cancer or Crohn’s disease, an inflammatory disease that affects the gastrointestinal tract. The procedure is done by a qualified provider and involves the removal of a portion of the colon, the creation of a colostomy or ileostomy, and the creation of a mucous fistula.

5. When to use CPT code 44144

CPT code 44144 should be used when a provider performs a partial colectomy with resection, colostomy or ileostomy, and creation of a mucous fistula. It is important to review the range of excision procedures on the intestines (except rectum) to ensure the most appropriate code is selected.

6. Documentation requirements

To support a claim for CPT 44144, the provider must document the following information:

• Patient’s diagnosis necessitating the colectomy
• Details of the procedure, including the specific portions of the colon removed
• Documentation of the creation of the colostomy or ileostomy and mucous fistula
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 44144, ensure that the procedure meets the criteria outlined in the official description. It is important to review the specific billing guidelines provided by the payer to ensure accurate reporting. Additionally, consider any applicable modifiers or additional codes that may be necessary to accurately represent the procedure performed.

8. Historical information

CPT 44144 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.

9. Examples

1. A provider performs a partial colectomy with resection, colostomy, and creation of a mucous fistula for a patient with colorectal cancer.
2. During a surgical procedure, a provider removes a portion of the colon, creates an ileostomy, and creates a mucous fistula for a patient with Crohn’s disease.
3. A qualified provider performs a partial colectomy with resection, colostomy, and creation of a mucous fistula for a patient with diverticulitis.
4. During surgery, a provider removes a portion of the colon, creates a colostomy, and creates a mucous fistula for a patient with ulcerative colitis.
5. A patient undergoes a partial colectomy with resection, ileostomy, and creation of a mucous fistula to treat a gastrointestinal obstruction.
6. A provider performs a partial colectomy with resection, colostomy, and creation of a mucous fistula for a patient with a perforated colon.
7. During surgery, a provider removes a portion of the colon, creates an ileostomy, and creates a mucous fistula for a patient with ischemic colitis.
8. A qualified provider performs a partial colectomy with resection, colostomy, and creation of a mucous fistula for a patient with familial adenomatous polyposis.
9. During a surgical procedure, a provider removes a portion of the colon, creates a colostomy, and creates a mucous fistula for a patient with a colonic stricture.
10. A patient undergoes a partial colectomy with resection, ileostomy, and creation of a mucous fistula to treat a colonic volvulus.