How To Use CPT Code 44213

CPT 44213 describes the laparoscopic mobilization (take-down) of the splenic flexure performed in conjunction with partial colectomy. 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 44213?

CPT 44213 can be used to describe the laparoscopic mobilization (take-down) of the splenic flexure, which is performed in conjunction with a partial colectomy. This code is used when the provider needs to prepare a suitable length of the colon by mobilizing the splenic flexure during the same session as the partial resection.

2. Official Description

The official description of CPT code 44213 is: ‘Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure).’ This code should be used in conjunction with the primary procedure codes 44204-44208. For open procedures, use code 44139.

3. Procedure

1. During the laparoscopic procedure, the provider performs a mobilization (take-down) of the splenic flexure.
2. The provider dissects the tissues between the spleen and the splenic flexure of the colon.
3. The omentum, the part of the membrane lining the abdominal cavity, is preserved by separating it from the colon.
4. This allows exposure to the lienocolic ligament, which connects the high part of the splenic flexure to the bottom of the fibrous capsule surrounding the spleen.
5. The provider carefully divides the ligament to free the splenic flexure.
6. Once all procedures for the session are complete, the provider checks for bleeding, removes any instruments, and closes the incisions in the abdomen.

4. Qualifying circumstances

CPT 44213 is performed in conjunction with a partial colectomy and is used to mobilize the splenic flexure. This procedure is typically done when a suitable length of the colon needs to be prepared for partial resection. The provider must document the need for the mobilization and ensure that it is performed laparoscopically.

5. When to use CPT code 44213

CPT code 44213 should be used when the provider performs a laparoscopic mobilization (take-down) of the splenic flexure in conjunction with a partial colectomy. It is important to use this code only when the procedure is performed laparoscopically and in conjunction with the appropriate primary procedure codes.

6. Documentation requirements

To support a claim for CPT 44213, the provider must document the following information:

• The need for the mobilization of the splenic flexure in conjunction with the partial colectomy
• The laparoscopic approach used for the procedure
• The specific steps taken during the mobilization, including the dissection of tissues, preservation of the omentum, exposure to the lienocolic ligament, and division of the ligament
• The closure of incisions and any post-procedure instructions

7. Billing guidelines

When billing for CPT 44213, ensure that the procedure is performed laparoscopically and in conjunction with the appropriate primary procedure codes (44204-44208). It is important to note that this is an add-on code, so it should not be reported without an appropriate primary code. If the procedure is performed using an open approach, use code 44139 instead.

8. Historical information

CPT 44213 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition. It is worth noting that this procedure was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A surgeon performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with colon cancer.
2. A gastroenterologist performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with diverticulitis.
3. A general surgeon performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with ulcerative colitis.
4. A colorectal surgeon performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with Crohn’s disease.
5. A surgical oncologist performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with a large polyp in the colon.
6. A bariatric surgeon performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient undergoing weight loss surgery.
7. A colorectal surgeon performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with a colonic obstruction.
8. A general surgeon performing a laparoscopic mobilization of the splenic flexure in conjunction with a partial colectomy for a patient with a perforated colon.