How To Use CPT Code 44626

CPT 44626 describes the closure of an enterostomy in the large or small intestine, along with resection and colorectal anastomosis. 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 44626?

CPT 44626 is used to describe the closure of an enterostomy in the large or small intestine, along with resection and colorectal anastomosis. This procedure involves surgically creating a connection between the colon and the rectum, allowing the patient to pass stool normally. It is important to note that for laparoscopic procedures, CPT code 44227 should be used instead.

2. Official Description

The official description of CPT code 44626 is: ‘Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of Hartmann type procedure).’ It is worth mentioning that this code was added to the Current Procedural Terminology system on January 1, 1998.

3. Procedure

1. To perform CPT 44626, the healthcare provider begins by making an incision near the site of the enterostomy.
2. They then detach the intestine used for the enterostomy from the opening in the abdominal wall and close the enterostomy with sutures or staples.
3. The provider proceeds to close the site of the previous stoma, or opening of the enterostomy on the skin, in layers.
4. Next, they carefully dissect away adhesions to free up the colon down to the rectum.
5. The diseased section of the colon is resected, and the healthy end of the colon is anastomosed, or joined, to the rectum.
6. If the patient previously underwent a Hartmann procedure, the provider dissects adhesions and frees up the colon, typically the descending colon, to provide as much length as possible.
7. The end of the intestine that was used for the enterostomy is resected to provide a healthy site for anastomosis.
8. The provider also resects the end of the rectal stump and attaches it to the remaining intestine.
9. Finally, the provider removes all instruments, checks for bleeding, and closes the abdominal incision in layers.

4. Qualifying circumstances

CPT 44626 is performed on patients who have previously undergone an enterostomy and require closure of the opening in the intestine. This procedure is typically indicated for patients with advanced diverticulitis or colon cancer. It is important to note that laparoscopic procedures should be coded using CPT code 44227 instead.

5. When to use CPT code 44626

CPT code 44626 should be used when a healthcare provider performs the closure of an enterostomy in the large or small intestine, along with resection and colorectal anastomosis. However, it is important to note that this code should not be used for laparoscopic procedures, as they have a separate code (44227).

6. Documentation requirements

To support a claim for CPT 44626, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for closure of the enterostomy
• Details of the procedure, including the specific steps taken
• Date of the procedure
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 44626, ensure that the procedure meets the criteria outlined in the official description. It is important to note that this code should not be reported with other codes unless specified. Additionally, be aware of any specific billing guidelines provided by insurance companies or payers.

8. Historical information

CPT code 44626 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates or changes to the code since its addition. It is worth mentioning that this procedure was previously listed under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient who previously underwent an enterostomy for diverticulitis requires closure of the opening in the large intestine, along with resection and colorectal anastomosis.
2. A patient with colon cancer underwent a Hartmann procedure and now needs the enterostomy closure, resection, and colorectal anastomosis to restore normal bowel function.
3. An individual with a history of Crohn’s disease had an enterostomy and now requires the closure, resection, and colorectal anastomosis to improve their quality of life.
4. A patient who underwent an enterostomy due to a traumatic injury now needs the opening closed and the intestine reconnected to the rectum.
5. A person with a history of inflammatory bowel disease had an enterostomy and now requires the closure, resection, and colorectal anastomosis to alleviate symptoms and improve digestion.