How To Use CPT Code 44146

CPT 44146 describes a specific surgical procedure known as colectomy with coloproctostomy and colostomy. 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 44146?

CPT 44146 is a code used to describe a surgical procedure called colectomy with coloproctostomy and colostomy. This procedure involves the removal of a portion of the colon, the creation of an artificial passage between the colon and rectum (coloproctostomy), and the creation of an opening in the colon that connects to the skin (colostomy).

2. Official Description

The official description of CPT code 44146 is: ‘Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy.’ This code is used when a provider performs a partial colectomy, creates a coloproctostomy, and performs a colostomy procedure.

3. Procedure

1. The provider begins by making an incision in the abdomen to access the affected portion of the colon.
2. They then remove the affected portion of the colon and perform an anastomosis, connecting the remaining colon to the rectum low in the pelvis.
3. During the same procedure, the provider creates a colostomy, which involves making an artificial opening in a loop of the colon and connecting it to the skin through a separate incision in the abdomen.
4. The colostomy is usually temporary and serves to redirect feces until the coloproctostomy heals.
5. After completing the necessary connections and ensuring there is no bleeding, the provider closes the incision in the abdomen used for the colectomy.

4. Qualifying circumstances

CPT 44146 is typically performed on patients with conditions such as colorectal cancer or Crohn’s disease. These patients may experience symptoms such as abdominal pain, fever, and weight loss. The procedure is performed by a qualified provider and involves the removal of a portion of the colon, the creation of a coloproctostomy, and the creation of a colostomy.

5. When to use CPT code 44146

CPT code 44146 should be used when a provider performs a colectomy with coloproctostomy and colostomy procedure. It is important to accurately document the specific details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 44146, the provider must document the following information:

• Patient’s diagnosis necessitating the colectomy procedure
• Details of the colectomy, including the specific portion of the colon removed
• Description of the coloproctostomy procedure
• Explanation of the colostomy creation
• Any additional relevant details or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 44146, it is important to ensure that the procedure performed matches the description provided by the code. Additionally, follow any specific billing guidelines provided by the payer or coding guidelines. It is also important to review other related codes to ensure accurate reporting.

8. Historical information

CPT code 44146 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 patient with colorectal cancer undergoes a colectomy with coloproctostomy and colostomy to remove the affected portion of the colon and create an artificial passage for waste elimination.
2. A provider performs a colectomy with coloproctostomy and colostomy on a patient with Crohn’s disease to alleviate symptoms and improve gastrointestinal function.
3. During a surgical procedure, a provider performs a colectomy with coloproctostomy and colostomy to address complications from diverticulitis.
4. A patient with a severe infection in the colon undergoes a colectomy with coloproctostomy and colostomy to remove the infected portion and prevent further complications.
5. A provider performs a colectomy with coloproctostomy and colostomy on a patient with a congenital abnormality of the colon to improve their overall health and quality of life.
6. During a surgical intervention, a provider performs a colectomy with coloproctostomy and colostomy to address complications from a previous surgery.
7. A patient with a large polyp in the colon undergoes a colectomy with coloproctostomy and colostomy to remove the polyp and prevent further complications.
8. A provider performs a colectomy with coloproctostomy and colostomy on a patient with a perforation in the colon to repair the damage and restore normal function.
9. During a surgical procedure, a provider performs a colectomy with coloproctostomy and colostomy to address complications from inflammatory bowel disease.
10. A patient with a blockage in the colon undergoes a colectomy with coloproctostomy and colostomy to remove the obstruction and restore normal bowel function.