How To Use CPT Code 44314

CPT 44314 describes the revision of ileostomy, specifically in complicated cases that require in-depth reconstruction as a separate procedure. 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 44314?

CPT 44314 is used to describe the revision of ileostomy, particularly in complicated cases that require extensive reconstruction. This code is specifically designated for situations where the provider releases the ileal intestinal segment from its stoma, removes scar tissue around the stoma, and recreates the stoma at a new site in the abdominal wall.

2. Official Description

The official description of CPT code 44314 is: ‘Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure).’ This code is used when the provider performs a complex revision of an ileostomy, involving in-depth reconstruction as a separate procedure.

3. Procedure

1. During the procedure, the provider begins by making an abdominal incision and releasing the ileal intestinal segment from its attachments to the abdominal wall.
2. Scar tissue around the stoma is excised as necessary to facilitate the revision.
3. The provider then recreates the stoma at a new site in the abdominal wall, connecting the opening in the ileum to an opening through the skin.
4. Finally, the provider repairs the abdominal wall and skin at the previous stoma site to complete the revision.

4. Qualifying circumstances

CPT 44314 is used in cases where the revision of an ileostomy is complicated and requires in-depth reconstruction. This procedure is typically performed when there is a need to release the ileal intestinal segment from its stoma, remove scar tissue, and create a new stoma at a different site in the abdominal wall. It is important to note that this code should not be reported if the revision is performed as an integral part of a larger procedure.

5. When to use CPT code 44314

CPT code 44314 should be used when the provider performs a separate and complex revision of an ileostomy that involves in-depth reconstruction. It is important to ensure that the revision is not performed as an integral part of another procedure. This code is specifically designated for cases where the provider releases the ileal intestinal segment, removes scar tissue, and recreates the stoma at a new site in the abdominal wall.

6. Documentation requirements

To support a claim for CPT 44314, the provider must document the following information:

• Indication for the revision of the ileostomy
• Details of the in-depth reconstruction performed
• Date of the procedure
• Start and end time of the procedure
• Any complications encountered during the revision
• Repair of the abdominal wall and skin at the previous stoma site
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 44314, it is important to ensure that the revision of the ileostomy is a separate and complex procedure. This code should not be reported if the revision is performed as an integral part of another procedure. It is also essential to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT 44314 was added to the Current Procedural Terminology system on January 1, 1990. It was initially included in the Inpatient Only (IPO) list in 2017, but was later removed in 2021. However, as of 2022, it has been added back to the Inpatient Only (IPO) list.

9. Examples

1. A patient with Crohn’s disease undergoes a revision of their ileostomy due to complications, requiring in-depth reconstruction.
2. A provider performs a separate procedure to revise an ileostomy that has become obstructed, necessitating in-depth reconstruction.
3. In a complex case, a patient’s ileostomy is revised to address a parastomal hernia, involving in-depth reconstruction as a separate procedure.
4. A revision of an ileostomy is performed on a patient with a history of inflammatory bowel disease, requiring extensive reconstruction as a separate procedure.
5. A provider performs a complex revision of an ileostomy to address recurrent infections, involving in-depth reconstruction as a separate procedure.
6. In a complicated case, a patient’s ileostomy is revised to improve functionality and address complications, requiring in-depth reconstruction as a separate procedure.
7. A separate procedure is performed to revise an ileostomy that has become prolapsed, necessitating in-depth reconstruction.
8. A patient with a history of bowel obstruction undergoes a revision of their ileostomy, involving in-depth reconstruction as a separate procedure.
9. In a complex case, a provider performs a revision of an ileostomy to address a stoma-related complication, requiring in-depth reconstruction as a separate procedure.
10. A patient with a history of Crohn’s disease undergoes a revision of their ileostomy due to recurrent inflammation, necessitating in-depth reconstruction as a separate procedure.