How To Use CPT Code 44345

CPT 44345 describes the complicated revision of a colostomy, involving in-depth reconstruction as a separate procedure. 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 44345?

CPT 44345 can be used to describe the complicated revision of a colostomy, specifically involving in-depth reconstruction. This code is used when the provider releases the colon segment from its stoma, removes scar tissue around the stoma, and reattaches the stoma at a new site in the abdominal wall.

2. Official Description

The official description of CPT code 44345 is: ‘Revision of colostomy; complicated (reconstruction in-depth) (separate procedure).’

3. Procedure

1. When performing CPT 44345, the provider begins by making an abdominal incision and cutting the colon free from its attachments to the abdominal wall.
2. They then excise any scar tissue around the stoma as necessary.
3. The provider reattaches the colon at a new site, connecting the opening in the colon to a new opening through the skin.
4. Finally, the provider repairs the abdominal wall and skin at the previous stoma site.

4. Qualifying circumstances

CPT 44345 is used for patients who require a complicated revision of a colostomy. This may involve in-depth reconstruction due to factors such as extensive scar tissue or other complications. The procedure is performed by a qualified healthcare provider who is experienced in performing colostomy revisions.

5. When to use CPT code 44345

CPT code 44345 should be used when the provider performs a complicated revision of a colostomy that involves in-depth reconstruction as a separate procedure. It should not be reported if the service is performed as an integral part of a larger procedure.

6. Documentation requirements

To support a claim for CPT 44345, the provider must document the following information:

• Patient’s diagnosis and the need for a complicated revision of the colostomy
• Details of the in-depth reconstruction performed
• Date and duration of the procedure
• Any complications encountered during the procedure
• 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 44345, ensure that the procedure meets the criteria for a complicated revision of a colostomy involving in-depth reconstruction. It should be reported as a separate procedure and not as part of a larger procedure. Review any additional guidelines provided by payers to ensure accurate billing and reimbursement.

8. Historical information

CPT 44345 was added to the Current Procedural Terminology system on January 1, 1990. It was initially removed from the Inpatient Only (IPO) list in 2017 but was later added back to the list in 2022.

9. Examples

1. A surgeon performs a complicated revision of a colostomy for a patient with extensive scar tissue around the stoma.
2. A gastroenterologist performs an in-depth reconstruction of a colostomy for a patient with a paracolostomy hernia.
3. A general surgeon performs a complicated revision of a colostomy and repairs a paracolostomy hernia during the same procedure.
4. A colorectal surgeon performs a complicated revision of a colostomy and resects a portion of the colon with anastomosis.
5. A surgical team performs a complicated revision of a colostomy and creates a new enterostomy at the same site.