How To Use CPT Code 44188

CPT 44188 describes a laparoscopic procedure for colostomy or skin level cecostomy. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44188?

CPT 44188 is used to describe a laparoscopic procedure for colostomy or skin level cecostomy. This code is specifically for the surgical creation of an opening in the colon or cecum, which may connect to an opening through the skin forming a stoma. It is important to note that this code is not used for open procedures, which have a separate code (44320).

2. Official Description

The official description of CPT code 44188 is: ‘Laparoscopy, surgical, colostomy or skin level cecostomy.’ It is important to note that this code should not be reported in conjunction with code 44970.

3. Procedure

1. The laparoscopic procedure begins with the provider making a small incision at the umbilicus.
2. Gas is then insufflated into the abdomen to lift the abdominal wall away from the organs, improving visualization.
3. The provider uses instruments inserted through additional incisions to remove any adhesions using a scalpel, cautery, or blunt dissection.
4. The target area of the colon or cecum is identified, brought to the abdominal wall, and incised.
5. The incised area is sutured in place to connect to an opening in the skin, forming a stoma.
6. Hemostasis is ensured, and the small abdominal incisions are closed in layers.

4. Qualifying circumstances

CPT 44188 is performed when there is a need to create an opening in the colon or cecum, either for colostomy or skin level cecostomy. This procedure is typically performed laparoscopically, and the patient must be appropriately prepped and anesthetized. Adhesions may need to be addressed during the procedure, and hemostasis must be ensured. It is important to note that this code should not be reported in conjunction with code 44970.

5. When to use CPT code 44188

CPT code 44188 should be used when a laparoscopic procedure is performed to create a colostomy or skin level cecostomy. It is important to use this code only for laparoscopic procedures and not for open procedures, which have a separate code (44320).

6. Documentation requirements

To support a claim for CPT 44188, the provider must document the following information:

• Indication for the procedure
• Details of the laparoscopic approach
• Description of any adhesions addressed during the procedure
• Confirmation of successful creation of the colostomy or skin level cecostomy
• Documentation of hemostasis
• Closure of the small abdominal incisions

7. Billing guidelines

When billing for CPT 44188, ensure that the procedure is performed laparoscopically. Do not report this code in conjunction with code 44970. It is important to follow the specific guidelines provided by the payer and ensure accurate documentation to support the claim.

8. Historical information

CPT 44188 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. However, it is important to stay updated with any changes or revisions that may occur in the future.

9. Examples

1. A laparoscopic procedure performed to create a colostomy for a patient with colorectal cancer.
2. A laparoscopic procedure performed to create a skin level cecostomy for a patient with a bowel obstruction.
3. A laparoscopic procedure performed to create a colostomy for a patient with inflammatory bowel disease.
4. A laparoscopic procedure performed to create a skin level cecostomy for a patient with diverticulitis.
5. A laparoscopic procedure performed to create a colostomy for a patient with a perforated colon.
6. A laparoscopic procedure performed to create a skin level cecostomy for a patient with a colonic stricture.
7. A laparoscopic procedure performed to create a colostomy for a patient with a rectal tumor.
8. A laparoscopic procedure performed to create a skin level cecostomy for a patient with a colonic polyp.
9. A laparoscopic procedure performed to create a colostomy for a patient with a rectovaginal fistula.
10. A laparoscopic procedure performed to create a skin level cecostomy for a patient with a colonic abscess.