How To Use CPT Code 44202

CPT 44202 describes the laparoscopic removal of part of the small intestine with a single resection and anastomosis. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44202?

CPT 44202 can be used to describe the laparoscopic removal of a portion of the small intestine with a single resection and anastomosis. This code is used when the provider performs a minimally invasive surgical procedure to remove a specific segment of the small intestine and then reconnects the cut ends in an end to end, end to side, or side to side manner, depending on the location of the resection.

2. Official Description

The official description of CPT code 44202 is: ‘Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis.’

3. Procedure

1. The provider begins by making a small incision at the umbilicus and insufflating the abdomen with gas to improve visualization.
2. Additional small incisions are made, and a camera and instruments are inserted to perform the laparoscopic procedure.
3. Any adhesions present are carefully separated using a scalpel, cautery, or blunt dissection.
4. The provider removes the targeted portion of the small intestine.
5. The cut ends of the intestine are then reconnected in an end to end, end to side, or side to side manner, depending on the location of the resection.
6. Hemostasis is ensured, and the abdominal incisions are closed in layers.

4. Qualifying circumstances

CPT 44202 is typically performed on patients who require the removal of a specific segment of the small intestine. This procedure may be necessary due to conditions such as tumors, strictures, or other diseases affecting the small intestine. The laparoscopic approach is chosen to minimize invasiveness and promote faster recovery. The provider must have the necessary qualifications and expertise to perform the procedure.

5. When to use CPT code 44202

CPT code 44202 should be used when the provider performs a laparoscopic enterectomy, which involves the removal of a portion of the small intestine with a single resection and anastomosis. This code is appropriate when the procedure is performed using a minimally invasive approach. If the provider performs an open procedure instead of laparoscopy, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 44202, the provider must document the following information:

• Patient’s diagnosis necessitating the enterectomy
• Details of the laparoscopic procedure, including the specific segment of the small intestine removed
• Description of the reconnection method used (end to end, end to side, or side to side)
• Documentation of hemostasis and closure of abdominal incisions
• Any additional relevant details or complications encountered during the procedure

7. Billing guidelines

When billing for CPT 44202, ensure that the procedure is performed laparoscopically and involves the removal of a portion of the small intestine with a single resection and anastomosis. It is important to follow the specific guidelines provided by the payer regarding documentation and coding requirements. Additionally, be aware of any modifiers or additional codes that may be necessary to accurately report the procedure.

8. Historical information

CPT 44202 was added to the Current Procedural Terminology system on January 1, 2000. The code underwent a change on January 1, 2002, with the description being updated to specify “intestinal resection, with anastomosis (intra or extracorporeal).” In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes a laparoscopic enterectomy with a single resection and anastomosis to remove a tumor in the small intestine.
2. A provider performs a laparoscopic procedure to remove a strictured segment of the small intestine and reconnects the cut ends in an end to side manner.
3. A laparoscopic enterectomy with a single resection and anastomosis is performed on a patient with Crohn’s disease to alleviate symptoms and improve intestinal function.
4. A provider performs a laparoscopic procedure to remove a diseased portion of the small intestine and reconnects the cut ends in an end to end manner.
5. A patient undergoes a laparoscopic enterectomy with a single resection and anastomosis to treat a small bowel obstruction caused by adhesions.
6. A provider performs a laparoscopic procedure to remove a segment of the small intestine affected by ischemia and reconnects the cut ends in a side to side manner.
7. A laparoscopic enterectomy with a single resection and anastomosis is performed on a patient with a gastrointestinal stromal tumor (GIST) in the small intestine.
8. A provider performs a laparoscopic procedure to remove a portion of the small intestine affected by diverticulitis and reconnects the cut ends in an end to side manner.