How To Use CPT Code 44320

CPT 44320 describes the procedure of creating an artificial connection between the colon and the skin, known as a colostomy or skin level cecostomy. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 44320?

CPT 44320 is used to describe the surgical procedure of creating an artificial connection between the colon and the skin. This procedure, known as a colostomy or skin level cecostomy, involves pulling a small loop of the large intestine through an incision in the abdominal wall and stitching it to the abdominal wall. The purpose of this procedure is to provide direct access to the intestines, typically for emptying them.

2. Official Description

The official description of CPT code 44320 is: ‘Colostomy or skin level cecostomy.’

3. Procedure

1. The provider makes an open incision over the target area in the patient’s abdomen.
2. They identify the specific part of the colon or cecum and bring it through the abdominal wall.
3. The provider stitches the colon or cecum to the abdominal wall, creating a connection between the intestine and the skin.
4. An incision is made through the wall and into the intestine, allowing for attachment of an external appliance to the stoma.
5. The provider ensures hemostasis, removes any instruments, and closes the incision in layers.

4. Qualifying circumstances

CPT 44320 is performed for patients who require a colostomy or skin level cecostomy. This procedure may be necessary for the management of conditions such as Crohn’s disease or cancer. It is important to note that CPT 44320 should not be reported in conjunction with certain other codes, including 44141, 44144, 44146, 44605, 45110, 45119, 45126, 45563, 45805, 45825, 50810, 51597, 57307, or 58240.

5. When to use CPT code 44320

CPT code 44320 should be used when a provider performs a colostomy or skin level cecostomy procedure. It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code.

6. Documentation requirements

To support a claim for CPT 44320, the provider must document the following information:

• Patient’s diagnosis and the medical necessity for the colostomy or skin level cecostomy
• Details of the procedure performed, including the specific part of the colon or cecum involved
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 44320, it is important to follow the appropriate guidelines. Ensure that the procedure meets the criteria outlined in the official description of the code. Additionally, be aware of any codes that should not be reported in conjunction with CPT 44320. It is important to accurately report the procedure to ensure proper reimbursement.

8. Historical information

CPT 44320 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including updates on January 1, 2006, and January 1, 2010. It is important to stay updated on any changes or revisions to the code.

9. Examples

1. A patient with Crohn’s disease undergoes a colostomy procedure to manage their condition.
2. A patient with colon cancer requires a skin level cecostomy to provide direct access to the intestines.
3. A provider performs a colostomy procedure for a patient with a severe bowel obstruction.
4. A skin level cecostomy is performed on a patient with diverticulitis to alleviate symptoms and improve bowel function.
5. A colostomy procedure is performed on a patient with a perforated colon due to trauma.
6. A patient with ulcerative colitis undergoes a skin level cecostomy to manage their symptoms.
7. A provider performs a colostomy procedure on a patient with a congenital abnormality of the colon.
8. A skin level cecostomy is performed on a patient with a rectal cancer recurrence to provide an alternative route for waste elimination.
9. A patient with an intestinal obstruction undergoes a colostomy procedure to relieve the blockage.
10. A provider performs a skin level cecostomy on a patient with a severe case of constipation that does not respond to other treatments.