How To Use CPT Code 44316

CPT 44316 describes a specific surgical procedure known as continent ileostomy or the Kock procedure. This article will provide an overview of CPT code 44316, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44316?

CPT 44316 is a code that represents the surgical procedure known as continent ileostomy or the Kock procedure. It involves the creation of an opening in the abdominal wall and connecting it to an ileal intestinal pouch. This procedure is typically performed for patients who are able to manage their own ostomies and manually empty their intestines multiple times a day.

2. Official Description

The official description of CPT code 44316 is: ‘Continent ileostomy (Kock procedure) (separate procedure).’ This code should not be used for fiberoptic evaluation, which has its own specific code (44385).

3. Procedure

1. During the continent ileostomy procedure, the provider makes an abdominal incision after the patient is appropriately prepped and anesthetized.
2. The provider then creates an ileal pouch by folding the terminal ileum, a part of the small intestine.
3. This pouch serves as a reservoir for the continent stoma, which allows the patient to hold urine or feces until an appropriate time for discharge.
4. The end of the pouch, which functions like a valve, is connected to the skin and secured in place.
5. The provider ensures hemostasis, removes any instruments, and closes the incision in layers.

4. Qualifying circumstances

Continent ileostomy or the Kock procedure is performed for patients who are able to manage their own ostomies and manually empty their intestines several times a day. It is commonly used for patients with conditions such as Crohn’s disease, which can lead to bowel obstruction and other complications. The procedure is performed by a qualified healthcare professional and requires the creation of an opening in the abdominal wall and connection to an ileal intestinal pouch.

5. When to use CPT code 44316

CPT code 44316 should be used when the provider performs the continent ileostomy procedure as a separate and distinct procedure. It should not be reported if the procedure is performed as an integral part of a larger procedure. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT code 44316, the provider must document the following information:

• Patient’s diagnosis and indication for the continent ileostomy procedure
• Details of the procedure, including the creation of the ileal pouch and connection to the skin
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 44316, ensure that the procedure is performed as a separate and distinct procedure. Do not report this code if the procedure is performed as an integral part of a larger procedure. It is important to follow any specific billing guidelines provided by the payer to ensure accurate reimbursement.

8. Historical information

CPT code 44316 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient with Crohn’s disease undergoes a continent ileostomy procedure to manage their bowel obstruction and complications.
2. A qualified healthcare professional performs a separate and distinct continent ileostomy procedure for a patient who is able to manage their own ostomy and manually empty their intestines.
3. A provider performs the Kock procedure as a separate procedure for a patient with the appropriate indications and ability to manage their own ostomy.
4. A continent ileostomy procedure is performed for a patient with Crohn’s disease, allowing them to hold urine or feces until an appropriate time for discharge.
5. A provider performs a continent ileostomy procedure as a separate and distinct procedure for a patient who meets the qualifying circumstances.
6. A patient with the ability to manage their own ostomy undergoes a continent ileostomy procedure to improve their quality of life.
7. A qualified healthcare professional performs a separate and distinct continent ileostomy procedure for a patient with the appropriate indications and ability to manage their own ostomy.
8. A provider performs the Kock procedure as a separate procedure for a patient who is able to manually empty their intestines multiple times a day.
9. A continent ileostomy procedure is performed for a patient with Crohn’s disease, allowing them to maintain continence and avoid the constant use of an external appliance.
10. A provider performs a continent ileostomy procedure as a separate and distinct procedure for a patient who meets the qualifying circumstances and can manage their own ostomy.