How To Use CPT Code 44604

CPT 44604 describes the procedure of suturing a tear or hole in the large intestine without the need for a colostomy. 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 44604?

CPT 44604 is used to describe the surgical procedure of suturing a tear or hole in the large intestine. This procedure is performed to repair a perforated ulcer, diverticulum, wound, injury, or rupture in the large intestine. It does not involve the creation of a colostomy, which is a surgically created passage from the large intestine to the external surface of the abdomen.

2. Official Description

The official description of CPT code 44604 is: ‘Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy.’

3. Procedure

1. The patient is positioned supine on the operating table and prepared for the procedure.
2. An incision is made over the target area of the large intestine.
3. The provider sutures the perforation of the large intestine in layers.
4. The abdomen is lavaged, or washed out, with an antibiotic solution or normal saline to clean out any leakage of the bowel or bleeding.
5. The lavage fluid is suctioned out, and the provider checks for bleeding and removes any instruments.
6. The abdominal incision is closed in layers.

4. Qualifying circumstances

CPT 44604 is used when there is a tear or hole in the large intestine that requires suturing. This can be due to various conditions such as a perforated ulcer, diverticulum, wound, injury, or rupture. The procedure is performed without the need for a colostomy, which is the diversion of food waste through a stoma on the skin.

5. When to use CPT code 44604

CPT code 44604 should be used when a tear or hole in the large intestine needs to be repaired through suturing. It is appropriate when a colostomy is not performed during the procedure. If a colostomy is performed, a different CPT code should be used to accurately describe the procedure.

6. Documentation requirements

To support a claim for CPT 44604, the following documentation is required:

• Diagnosis indicating the need for suturing of the large intestine
• Details of the procedure, including the specific location of the tear or hole
• Documentation of the layers of suturing performed
• Record of the lavage performed and the solution used
• Confirmation of any bleeding or instruments removed
• Description of the closure of the abdominal incision

7. Billing guidelines

When billing for CPT 44604, ensure that the procedure involves suturing of the large intestine without the need for a colostomy. It is important to accurately document the details of the procedure and provide the necessary supporting documentation. CPT code 44604 should not be reported if a colostomy is performed during the procedure.

8. Historical information

CPT code 44604 was added to the Current Procedural Terminology system on January 1, 1994. It has not undergone any updates since its addition. However, it is important to stay updated with any changes or revisions to the code in order to accurately report the procedure.

9. Examples

1. A surgeon performs CPT 44604 to suture a perforated ulcer in the large intestine of a patient.
2. A gastroenterologist uses CPT 44604 to repair a tear in the large intestine caused by a diverticulum.
3. A trauma surgeon sutures a wound in the large intestine of a patient who experienced an injury.
4. A general surgeon performs CPT 44604 to repair a rupture in the large intestine caused by trauma.
5. A colorectal surgeon uses CPT 44604 to suture multiple perforations in the large intestine of a patient.
6. An emergency physician performs CPT 44604 to repair a perforated ulcer in the large intestine of a patient in a life-threatening condition.
7. A surgical team uses CPT 44604 to suture a wound in the large intestine of a patient during an exploratory laparotomy.
8. A gastrointestinal surgeon performs CPT 44604 to repair a diverticulum that has ruptured in the large intestine.
9. A trauma surgeon sutures a tear in the large intestine caused by a penetrating injury using CPT 44604.
10. A general surgeon uses CPT 44604 to repair a rupture in the large intestine caused by a blunt force injury.