How To Use CPT Code 44300

CPT 44300 describes the placement of an enterostomy or cecostomy tube using an open approach. 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 44300?

CPT 44300 can be used to describe the placement of an enterostomy or cecostomy tube using an open approach. This procedure involves creating an artificial opening in the small intestines or cecum and connecting it to a small external opening. The tube is then placed to allow for direct feeding or decompression of the intestines.

2. Official Description

The official description of CPT code 44300 is: ‘Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure).’ It is important to note that this code should not be reported in conjunction with code 44701 for cannulation of the colon for intraoperative colonic lavage. For percutaneous placement of duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy tubes, including fluoroscopic imaging guidance, refer to codes 49441-49442.

3. Procedure

1. The provider begins by making an incision in the abdomen above the target area.
2. They then identify the specific area of interest and create an artificial opening into the small intestines or cecum.
3. An opening is also created through the body surface, typically through the abdominal wall.
4. A tube is placed and securely stitched in place in the intestinal opening.
5. The tube is brought to the outside of the body through a separate stab incision.
6. The provider ensures hemostasis, removes any instruments, and closes the abdominal incision used to create the intestinal opening.
7. The stoma is left open for feeding or other necessary purposes.

4. Qualifying circumstances

CPT 44300 is performed for various reasons, such as direct feeding of the patient or decompression of the intestines in cases of intestinal obstructions. It is important to note that this code should not be reported when the procedure is performed as an integral part of a larger procedure.

5. When to use CPT code 44300

CPT code 44300 should be used when the provider performs the placement of an enterostomy or cecostomy tube using an open approach as a separate procedure. It should not be reported when the procedure is performed as part of a larger procedure.

6. Documentation requirements

To support a claim for CPT 44300, the provider must document the following information:

• Patient’s diagnosis and the need for enterostomy or cecostomy tube placement
• Details of the procedure, including the specific approach used
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 44300, ensure that the procedure is performed as a separate procedure and not as part of a larger procedure. It is important to follow the specific guidelines and notes provided for this code. Additionally, be aware of any specific billing requirements from payers or insurance companies.

8. Historical information

CPT 44300 was added to the Current Procedural Terminology system on January 1, 1990. There have been several historical changes to the code, including updates to the description and its inclusion or exclusion from the Inpatient Only (IPO) list.

9. Examples

1. A surgeon performs the placement of an enterostomy tube for direct feeding in a patient with intestinal obstruction.
2. A gastroenterologist places a cecostomy tube for decompression in a patient with a cecal volvulus.
3. A pediatric surgeon performs the placement of an enterostomy tube for direct feeding in an infant with short bowel syndrome.
4. An interventional radiologist places a cecostomy tube for decompression in a patient with a large bowel obstruction.
5. A general surgeon performs the placement of an enterostomy tube for direct feeding in a patient with severe malnutrition.
6. A colorectal surgeon places a cecostomy tube for decompression in a patient with a sigmoid volvulus.
7. An oncology surgeon performs the placement of an enterostomy tube for direct feeding in a patient undergoing chemotherapy.
8. An interventional radiologist places a cecostomy tube for decompression in a patient with an obstructed colon due to cancer.
9. A pediatric surgeon performs the placement of an enterostomy tube for direct feeding in a child with congenital intestinal malrotation.
10. A gastroenterologist places a cecostomy tube for decompression in a patient with severe constipation.