How To Use CPT Code 44180

CPT 44180 describes a laparoscopic procedure known as enterolysis, which involves the removal of intestinal adhesions. This article will provide an overview of CPT 44180, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 44180?

CPT 44180 is a code used to describe a laparoscopic procedure called enterolysis. This procedure involves the surgical removal of intestinal adhesions, which are fibrous bands that form between tissues and organs, often as a result of previous surgery or injury. Enterolysis is performed using minimally invasive techniques, with small incisions made in the abdomen to insert a camera and specialized instruments. The provider then cuts apart the adhesions using a scalpel, cautery, or blunt dissection, ensuring hemostasis before closing the incisions.

2. Official Description

The official description of CPT code 44180 is: ‘Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure).’ This code specifically refers to the laparoscopic removal of intestinal adhesions and should not be reported when performed along with a related procedure in the same anatomic area or through the same incision, orifice, or surgical approach.

3. Procedure

1. After appropriate patient preparation and anesthesia, the provider makes a small incision at the umbilicus to access the abdominal cavity.
2. Gas is insufflated into the abdomen to create space and improve visualization.
3. Additional small incisions are made to insert a camera and specialized instruments.
4. The provider identifies and cuts apart the intestinal adhesions using a scalpel, cautery, or blunt dissection.
5. Hemostasis is ensured to stop any bleeding.
6. The small abdominal incisions are closed in layers.

4. Qualifying circumstances

CPT 44180 is performed on patients who have developed intestinal adhesions, which are fibrous bands that can cause complications and impair the normal functioning of the intestines. These adhesions often form as a result of previous abdominal surgeries or injuries. The procedure is typically performed by a surgeon or other qualified healthcare professional with expertise in laparoscopic techniques.

5. When to use CPT code 44180

CPT code 44180 should be used when the provider performs a laparoscopic enterolysis procedure to remove intestinal adhesions. It is important to note that this code should not be reported when performed along with a related procedure in the same anatomic area or through the same incision, orifice, or surgical approach. If the enterolysis is performed along with salpingolysis or ovariolysis, CPT code 58660 should be used instead.

6. Documentation requirements

To support a claim for CPT 44180, the provider must document the following information:

• Patient’s diagnosis indicating the presence of intestinal adhesions
• Description of the laparoscopic enterolysis procedure performed
• Date of the procedure
• Details of the incisions made and instruments used
• Confirmation of hemostasis and closure of incisions
• Any additional relevant information or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 44180, ensure that the procedure meets the criteria for a separate procedure and is not performed along with a related procedure in the same anatomic area or through the same incision, orifice, or surgical approach. If the enterolysis is performed with an unrelated procedure, modifier 59 (Distinct procedural service) should be appended to the code. It is important to review the documentation and ensure that the procedure is clearly documented as a separate procedure and not part of another related procedure.

8. Historical information

CPT code 44180 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates or changes to the code since its addition.

9. Examples

1. A surgeon performing a laparoscopic enterolysis procedure to remove intestinal adhesions in a patient who had previous abdominal surgery.
2. A gastroenterologist using laparoscopic techniques to cut apart intestinal adhesions in a patient with chronic abdominal pain.
3. A general surgeon performing a laparoscopic enterolysis procedure to relieve bowel obstruction caused by intestinal adhesions.
4. A gynecologist performing a laparoscopic enterolysis procedure in combination with salpingolysis to treat a patient with infertility due to adhesions.
5. A colorectal surgeon using laparoscopic techniques to remove intestinal adhesions in a patient with a history of inflammatory bowel disease.
6. A bariatric surgeon performing a laparoscopic enterolysis procedure to address complications from previous weight loss surgery.
7. A pediatric surgeon using laparoscopic techniques to remove intestinal adhesions in a child with a congenital gastrointestinal condition.
8. An oncology surgeon performing a laparoscopic enterolysis procedure to address adhesions in a patient with a history of abdominal cancer.
9. A urologist using laparoscopic techniques to cut apart intestinal adhesions in a patient with urinary tract complications.
10. A hepatobiliary surgeon performing a laparoscopic enterolysis procedure to address adhesions in a patient with liver disease.