How To Use CPT Code 44346

CPT 44346 describes the revision of a colostomy site and the repair of a paracolostomy hernia 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 44346?

CPT 44346 can be used to describe the revision of a previously constructed colostomy site and the repair of a paracolostomy hernia as a separate procedure. This code is used when the provider releases the intestinal segment from its stoma, returns the entrapped bowel of the hernia to its proper place, 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 44346 is: ‘Revision of colostomy; with repair of paracolostomy hernia (separate procedure).’

3. Procedure

1. The provider makes an abdominal incision and cuts the colon free from its attachments to the stoma in the abdominal wall.
2. The provider repairs the hernia in the area of the stoma by returning the entrapped bowel to its correct anatomic position and may secure it in place to reduce the chance of recurrent hernia.
3. The provider excises the scar tissue of the stoma as needed and reattaches the colon at a new site, connecting the opening in the colon to a new opening through the skin.
4. The provider further repairs the abdominal wall and skin at the previous stoma site.

4. Qualifying circumstances

Patients eligible to receive CPT 44346 services are those who require a revision of a colostomy site and repair of a paracolostomy hernia. A paracolostomy hernia occurs when a loop of bowel becomes entrapped in the part of the colon that was used to create the colostomy. The provider must perform the procedure as a separate procedure and not as an integral part of a larger procedure.

5. When to use CPT code 44346

CPT code 44346 should be used when the provider performs the revision of a colostomy site and repair of a paracolostomy hernia as a separate procedure. It should not be reported when the procedure is performed as an integral part of a larger procedure.

6. Documentation requirements

To support a claim for CPT 44346, the provider must document the following information:

• Patient’s diagnosis requiring the revision of the colostomy site and repair of the paracolostomy hernia
• Description of the procedure performed, including the release of the intestinal segment, repair of the hernia, excision of scar tissue, and reattachment of the colon at a new site
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 44346, ensure that the procedure is performed as a separate procedure and not as an integral part of a larger procedure. Do not report CPT 44346 if it is performed as an integral part of a larger procedure. Follow the appropriate coding guidelines and modifiers when reporting CPT 44346.

8. Historical information

CPT 44346 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 added back to the IPO list in 2022.

9. Examples

1. A provider performs a revision of a colostomy site and repair of a paracolostomy hernia as a separate procedure for a patient with a history of colostomy.
2. A patient presents with a paracolostomy hernia, and the provider performs a revision of the colostomy site and repair of the hernia as a separate procedure.
3. A provider performs a revision of a colostomy site and repair of a paracolostomy hernia as a separate procedure for a patient with recurrent hernia.
4. A patient with a colostomy site and paracolostomy hernia undergoes a revision of the site and repair of the hernia as a separate procedure performed by the provider.
5. A provider performs a revision of a colostomy site and repair of a paracolostomy hernia as a separate procedure for a patient with complications related to the colostomy.
6. A patient requires a revision of a colostomy site and repair of a paracolostomy hernia, and the provider performs the procedure as a separate procedure.
7. A provider performs a revision of a colostomy site and repair of a paracolostomy hernia as a separate procedure for a patient with a symptomatic hernia.
8. A patient with a colostomy site and paracolostomy hernia undergoes a revision of the site and repair of the hernia as a separate procedure performed by the provider.
9. A provider performs a revision of a colostomy site and repair of a paracolostomy hernia as a separate procedure for a patient with recurrent hernia.
10. A patient requires a revision of a colostomy site and repair of a paracolostomy hernia, and the provider performs the procedure as a separate procedure.