How To Use CPT Code 45120

CPT 45120 describes a surgical procedure that involves the complete removal of the rectum and the connection of the colon and anus. 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 45120?

CPT 45120 is a code used to describe a surgical procedure in which a qualified healthcare provider removes or bypasses a diseased portion of the rectum and connects the colon and anus. This procedure is performed using both an abdominal and perineal approach.

2. Official Description

The official description of CPT code 45120 is: ‘Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation)’

3. Procedure

1. The healthcare provider begins by making an abdominal incision after the patient is appropriately prepped and anesthetized.
2. Next, the provider locates the rectum and lower portion of the colon and divides the colon just above the diseased rectal segment.
3. The diseased rectal segment is then removed, and the lower portion of the colon is pulled closer to the anus using sutures through a perineal approach.
4. Alternatively, the provider may bypass the rectum by pulling the lower portion of the colon close to the anus with sutures.
5. Once the procedure is complete, the provider stops any bleeding and closes the wound by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 45120 is performed on patients with congenital megacolon, a birth disorder characterized by the dilation or overgrowth of a portion of the colon due to paralysis. The procedure is done by a qualified healthcare provider using both an abdominal and perineal approach.

5. When to use CPT code 45120

CPT code 45120 should be used when a complete proctectomy is performed, involving the removal of the rectum and the connection of the colon and anus. It is important to ensure that the procedure is performed using both an abdominal and perineal approach.

6. Documentation requirements

To support a claim for CPT 45120, the healthcare provider must document the following information:

• Patient’s diagnosis of congenital megacolon
• Details of the complete proctectomy procedure
• Specific approach used (abdominal and perineal)
• Date of the procedure
• Any additional procedures performed during the same session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 45120, ensure that the procedure is performed by a qualified healthcare provider using both an abdominal and perineal approach. It is important to follow the specific documentation requirements and guidelines provided by the payer. Additionally, consider any applicable modifiers or additional codes that may need to be reported in conjunction with CPT 45120.

8. Historical information

CPT 45120 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. However, it is important to stay updated with any changes or revisions made by the American Medical Association (AMA) or other relevant authorities.

9. Examples

1. A qualified healthcare provider performs a complete proctectomy on a patient with congenital megacolon, connecting the colon and anus using a pull-through procedure and anastomosis.
2. Using both an abdominal and perineal approach, a healthcare provider removes the diseased portion of the rectum and connects the colon and anus in a patient with congenital megacolon.
3. A complete proctectomy is performed by a qualified healthcare provider, bypassing the rectum and connecting the colon and anus using sutures through an abdominal and perineal approach.
4. During the procedure, a healthcare provider removes the diseased rectal segment and pulls the lower portion of the colon closer to the anus, achieving a complete proctectomy in a patient with congenital megacolon.
5. Using a pull-through procedure and anastomosis, a qualified healthcare provider performs a complete proctectomy on a patient with congenital megacolon, utilizing both an abdominal and perineal approach.
6. A healthcare provider performs a complete proctectomy on a patient with congenital megacolon, connecting the colon and anus through a pull-through procedure and anastomosis using an abdominal and perineal approach.
7. Using both an abdominal and perineal approach, a qualified healthcare provider removes the diseased rectal segment and connects the colon and anus in a patient with congenital megacolon.
8. A complete proctectomy is performed by a healthcare provider, bypassing the rectum and connecting the colon and anus using sutures through an abdominal and perineal approach in a patient with congenital megacolon.
9. During the procedure, a qualified healthcare provider removes the diseased portion of the rectum and pulls the lower portion of the colon closer to the anus, achieving a complete proctectomy in a patient with congenital megacolon.
10. Using a pull-through procedure and anastomosis, a healthcare provider performs a complete proctectomy on a patient with congenital megacolon, utilizing both an abdominal and perineal approach.