How To Use CPT Code 44208

CPT 44208 describes the laparoscopic colectomy procedure with coloproctostomy and colostomy. 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 44208?

CPT 44208 is used to describe a laparoscopic colectomy procedure with coloproctostomy and colostomy. This code is specifically for the partial removal of the colon, creating a connection between the colon and rectum, and creating a colostomy. It is important to note that this code is for the laparoscopic approach, and if an open procedure is performed, a different code should be used.

2. Official Description

The official description of CPT code 44208 is: ‘Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy.’ This code is used for the laparoscopic removal of part of the colon, creating a connection between the colon and rectum, and creating a colostomy.

3. Procedure

1. The laparoscopic colectomy procedure begins with the provider making small incisions in the abdomen, including one at the umbilicus.
2. A camera and instruments are inserted through the incisions to visualize and access the target area of the colon.
3. The provider uses surgical tools to cut apart any adhesions and remove the targeted portion of the colon.
4. After removing the colon, the provider creates an anastomosis, connecting the remaining proximal colon to the rectum.
5. To aid in healing, the provider also creates a colostomy, which involves bringing a loop of bowel through the abdominal wall to allow for the connection of an incision in the intestine to an incision in the skin.
6. The provider ensures hemostasis and closes the incisions in layers.

4. Qualifying circumstances

CPT 44208 is performed on patients who require a partial colectomy, coloproctostomy, and colostomy. This procedure is commonly performed on patients with colorectal cancer or Crohn’s disease. The laparoscopic approach is chosen to minimize invasiveness and promote faster recovery. It is important to note that this code is specific to the laparoscopic approach, and if an open procedure is performed, a different code should be used.

5. When to use CPT code 44208

CPT code 44208 should be used when a laparoscopic colectomy procedure with coloproctostomy and colostomy is performed. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If an open procedure is performed instead, a different code should be used.

6. Documentation requirements

To support a claim for CPT code 44208, the following documentation should be included:

• Patient’s diagnosis necessitating the colectomy procedure
• Details of the laparoscopic approach, including the specific steps performed
• Date of the procedure
• Any additional procedures or interventions performed
• Any complications or unexpected findings
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 44208, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The laparoscopic approach should be clearly documented, and if an open procedure is performed instead, a different code should be used. It is also important to follow any additional billing guidelines provided by payers or regulatory bodies.

8. Historical information

CPT code 44208 was added to the Current Procedural Terminology system on January 1, 2003. It has not undergone any updates since its addition. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with colorectal cancer undergoes a laparoscopic colectomy with coloproctostomy and colostomy.
2. A patient with Crohn’s disease requires a laparoscopic colectomy with coloproctostomy and colostomy to manage their symptoms.
3. A laparoscopic colectomy with coloproctostomy and colostomy is performed on a patient with a large polyp in their colon.
4. A laparoscopic colectomy with coloproctostomy and colostomy is performed as part of a treatment plan for diverticulitis.
5. A patient with ulcerative colitis undergoes a laparoscopic colectomy with coloproctostomy and colostomy to alleviate their symptoms.
6. A laparoscopic colectomy with coloproctostomy and colostomy is performed on a patient with a perforated colon.
7. A patient with a blockage in their colon requires a laparoscopic colectomy with coloproctostomy and colostomy to restore proper bowel function.
8. A laparoscopic colectomy with coloproctostomy and colostomy is performed on a patient with a large polyp in their rectum.
9. A patient with familial adenomatous polyposis undergoes a laparoscopic colectomy with coloproctostomy and colostomy as a preventive measure.
10. A laparoscopic colectomy with coloproctostomy and colostomy is performed on a patient with a recurrent colon obstruction.