How To Use CPT Code 44205

CPT 44205 describes a laparoscopic surgical procedure that involves the partial colectomy, with removal of the terminal ileum, and the creation of an ileocolostomy. This article will provide an overview of CPT code 44205, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 44205?

CPT 44205 is a code used to describe a laparoscopic surgical procedure that involves the partial removal of the colon, specifically the end of the ileum, and the connection of the remaining ileum and colon segments. This procedure is performed using minimally invasive techniques, with small incisions made in the abdomen to insert a camera and instruments for visualization and manipulation.

2. Official Description

The official description of CPT code 44205 is: ‘Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy.’ This code is specifically for laparoscopic procedures and should not be used for open procedures, which have a separate code (44160).

3. Procedure

1. The laparoscopic colectomy procedure begins with the provider making small incisions, including one at the umbilicus, to access the abdominal cavity.
2. Gas is then insufflated into the abdomen to create space and improve visualization.
3. The provider inserts a camera and other instruments through the incisions to perform the procedure.
4. Any adhesions, which are fibrous bands that form between tissues and organs, may be dissected using a scalpel, cautery, or blunt dissection.
5. The proximal colon and distal ileum, the last part of the small intestine, are removed.
6. The cut ends of the colon and ileum are then connected, typically in an end-to-side manner, to create an ileocolostomy.
7. The provider ensures hemostasis, or the stopping of bleeding, and closes the incisions in layers.

4. Qualifying circumstances

CPT code 44205 is used for patients who require a laparoscopic partial colectomy with removal of the terminal ileum and the creation of an ileocolostomy. This procedure may be necessary for various conditions affecting the colon, such as tumors, diverticulitis, or inflammatory bowel disease. It is important to note that this code is specific to laparoscopic procedures and should not be used for open procedures.

5. When to use CPT code 44205

CPT code 44205 should be used when a laparoscopic partial colectomy is performed, involving the removal of the terminal ileum and the creation of an ileocolostomy. It is important to ensure that the procedure is performed using laparoscopic techniques and not open surgery, as there is a separate code for open procedures (44160).

6. Documentation requirements

To support a claim for CPT code 44205, the following documentation is required:

• Patient’s diagnosis necessitating the laparoscopic partial colectomy
• Description of the procedure performed, including the removal of the terminal ileum and the creation of an ileocolostomy
• Date of the procedure
• Details of any complications or additional procedures performed
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 44205, it is important to ensure that the procedure was performed laparoscopically and not as an open procedure. If an open procedure was performed, the appropriate code to use is 44160. Additionally, it is important to follow any specific billing guidelines provided by insurance carriers or payers to ensure accurate reimbursement.

8. Historical information

CPT code 44205 was added to the Current Procedural Terminology system on January 1, 2002. Since its addition, there have been no updates or changes to the code.

9. Similar codes to CPT code 44205

Five similar codes to CPT code 44205 include:

• CPT 44202: Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum, with coloproctostomy
• CPT 44203: Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum, with ileorectal anastomosis
• CPT 44204: Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum, with ileostomy and creation of colonic reservoir (eg, Kock pouch)
• CPT 44206: Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum, with ileorectal anastomosis, with coloproctostomy
• CPT 44207: Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum, with ileostomy and creation of colonic reservoir (eg, Kock pouch), with coloproctostomy

9. Examples

1. A patient with diverticulitis undergoes a laparoscopic partial colectomy with removal of the terminal ileum and the creation of an ileocolostomy.
2. A laparoscopic procedure is performed on a patient with a colon tumor, involving the removal of the terminal ileum and the creation of an ileocolostomy.
3. A patient with inflammatory bowel disease requires a laparoscopic partial colectomy with removal of the terminal ileum and the creation of an ileocolostomy.
4. A laparoscopic procedure is performed on a patient with a colonic polyp, involving the removal of the terminal ileum and the creation of an ileocolostomy.
5. A patient with a colonic stricture undergoes a laparoscopic partial colectomy with removal of the terminal ileum and the creation of an ileocolostomy.
6. A laparoscopic procedure is performed on a patient with colonic ischemia, involving the removal of the terminal ileum and the creation of an ileocolostomy.
7. A patient with colonic diverticulosis requires a laparoscopic partial colectomy with removal of the terminal ileum and the creation of an ileocolostomy.
8. A laparoscopic procedure is performed on a patient with a colonic polyp, involving the removal of the terminal ileum and the creation of an ileocolostomy.