How To Use CPT Code 44151

CPT 44151 describes the surgical procedure known as colectomy with continent ileostomy. 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 44151?

CPT 44151 is used to describe a surgical procedure called colectomy with continent ileostomy. This procedure involves the removal of the entire colon and the creation of an ileal pouch from the terminal ileum. The ileal pouch is then connected to the skin of the abdomen as a continent ileostomy, which allows the patient to manually empty it several times a day without the need for an external appliance.

2. Official Description

The official description of CPT code 44151 is: ‘Colectomy, total, abdominal, without proctectomy; with continent ileostomy.’

3. Procedure

1. The surgeon makes a midline abdominal incision from the xiphoid to the pubis.
2. The surrounding structures are dissected to reach the affected area of the colon.
3. The colon is freed from its attachments and the blood vessels are ligated.
4. The colorectal junction and the terminal ileum are divided.
5. The entire colon is removed.
6. The terminal ileum is folded to create an ileal pouch.
7. The end of the pouch is brought to the skin of the abdomen through a separate incision as a continent ileostomy.
8. The incision in the abdomen is closed.

4. Qualifying circumstances

CPT 44151 is performed in patients who require the removal of the entire colon and the creation of a continent ileostomy. This procedure is commonly performed in patients with colorectal cancer or Crohn’s disease, an inflammatory disease that affects the gastrointestinal tract. It is important to note that CPT 44151 does not involve the resection of the rectum.

5. When to use CPT code 44151

CPT code 44151 should be used when a surgeon performs a colectomy with continent ileostomy. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 44151, the surgeon must document the following information:

• Patient’s diagnosis necessitating the colectomy with continent ileostomy
• Details of the surgical procedure, including the incision site and the steps performed
• Confirmation that the entire colon was removed
• Description of the creation of the ileal pouch and the continent ileostomy
• Any additional procedures performed during the same surgical session
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT 44151, ensure that the procedure performed matches the description of the code. It is important to accurately document the details of the procedure to support the use of this code. CPT code 44151 should not be reported with codes 44140 to 44160, as these codes represent different procedures. Review the documentation thoroughly to ensure accurate coding and billing.

8. Historical information

CPT 44151 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement purposes.

9. Examples

1. A patient with colorectal cancer undergoes a colectomy with continent ileostomy to remove the entire colon and create an ileal pouch for waste elimination.
2. A patient with Crohn’s disease requires a colectomy with continent ileostomy to manage the symptoms and complications of the inflammatory disease.
3. A surgeon performs a colectomy with continent ileostomy in a patient with a history of ulcerative colitis to improve their quality of life.
4. A patient with a genetic predisposition to colon cancer undergoes a prophylactic colectomy with continent ileostomy to reduce the risk of developing the disease.
5. A surgeon performs a colectomy with continent ileostomy in a patient with a severe case of diverticulitis to alleviate symptoms and prevent further complications.
6. A patient with a history of chronic constipation undergoes a colectomy with continent ileostomy to improve their bowel function and quality of life.
7. A surgeon performs a colectomy with continent ileostomy in a patient with a large colon polyp that cannot be removed through other methods.
8. A patient with a rare genetic disorder requires a colectomy with continent ileostomy to manage their gastrointestinal symptoms and improve their overall health.
9. A surgeon performs a colectomy with continent ileostomy in a patient with a severe case of inflammatory bowel disease to alleviate symptoms and improve their quality of life.
10. A patient with a history of chronic diarrhea undergoes a colectomy with continent ileostomy to improve their bowel control and quality of life.