How To Use CPT Code 44150

CPT 44150 describes the surgical procedure known as colectomy, which involves the removal of the total colon without proctectomy. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44150?

CPT 44150 is a code used to describe a surgical procedure called colectomy. This procedure involves the complete removal of the colon, without the removal of the rectum. It is typically performed to treat conditions such as colorectal cancer or Crohn’s disease. The code specifically applies to colectomies performed through an abdominal approach, without the removal of the rectum.

2. Official Description

The official description of CPT code 44150 is: ‘Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy.’ This code is used when the provider removes the entire colon through an abdominal incision and either creates an ileostomy (connecting the end of the ileum to the skin) or an ileoproctostomy (connecting the ileum to the rectum).

3. Procedure

1. The surgeon makes a midline abdominal incision from the xiphoid to the pubis.
2. Surrounding structures are dissected to reach the affected area of the colon.
3. The colon is freed from its attachments and the blood vessels supplying it are ligated.
4. The colorectal junction and the terminal ileum are divided.
5. The entire colon is removed.
6. Depending on the patient’s condition, an ileostomy or ileoproctostomy is created.
7. Bleeding is checked, instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 44150 is performed on patients who require the complete removal of the colon without the removal of the rectum. It is commonly done for conditions such as colorectal cancer or Crohn’s disease. The procedure is typically performed by a surgeon and requires an abdominal approach. The decision to create an ileostomy or ileoproctostomy depends on the patient’s specific condition and other factors.

5. When to use CPT code 44150

CPT code 44150 should be used when a surgeon performs a total colectomy through an abdominal approach, without removing the rectum. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves a laparoscopic approach, a different code (44210) should be used instead.

6. Documentation requirements

To support a claim for CPT 44150, the surgeon must document the following information:

• Patient’s diagnosis and the need for a total colectomy
• Details of the surgical procedure performed, including the approach (abdominal) and whether an ileostomy or ileoproctostomy was created
• Date of the surgery
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and follow-up plans
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 44150, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the surgery and any additional procedures performed. Additionally, be aware of any specific billing guidelines or requirements from insurance providers or government payers. It is also important to review other codes related to colectomy (such as 44140 to 44160) to ensure the most appropriate code is selected.

8. Historical information

CPT 44150 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition. However, it is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A surgeon performs a total colectomy through an abdominal approach, creating an ileostomy for a patient with colorectal cancer.
2. A patient with Crohn’s disease undergoes a total colectomy without proctectomy, with the creation of an ileoproctostomy.
3. A surgeon removes the entire colon through an abdominal incision and creates an ileostomy for a patient with ulcerative colitis.
4. A total colectomy is performed on a patient with familial adenomatous polyposis, without removing the rectum, and an ileostomy is created.
5. A surgeon performs a total colectomy through an abdominal approach, creating an ileoproctostomy for a patient with diverticulitis.
6. An individual with a severe case of ischemic colitis undergoes a total colectomy without proctectomy, with the creation of an ileostomy.
7. A surgeon removes the entire colon through an abdominal incision and creates an ileoproctostomy for a patient with toxic megacolon.
8. A total colectomy is performed on a patient with chronic constipation, without removing the rectum, and an ileostomy is created.
9. A surgeon performs a total colectomy through an abdominal approach, creating an ileoproctostomy for a patient with volvulus.
10. An individual with a large colonic polyp undergoes a total colectomy without proctectomy, with the creation of an ileostomy.