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The CPT® Code 44322 refers to a surgical procedure involving the creation of a colostomy or skin level cecostomy, specifically when multiple biopsies are performed, often for conditions such as congenital megacolon. This procedure is classified as a separate procedure, indicating that it is distinct from other surgical interventions that may be performed concurrently. The process begins with a midline abdominal incision, allowing access to the peritoneal cavity, where the abdomen is thoroughly explored to identify any adhesions that may need to be lysed. The targeted segment of the colon or cecum is then mobilized, and a separate incision is made in the lower abdomen to prepare a stoma site, typically on the right side. The procedure involves clamping the colon or cecum above and below the planned transection site, followed by transection of the bowel. The distal segment is closed with sutures, while the proximal segment is exteriorized, everted, and sutured to the skin and subcutaneous tissue to create the stoma. The abdominal incision is subsequently closed, and a stomal appliance is applied. It is important to note that this code is specifically used when multiple biopsies of the intestinal mucosa are obtained for pathological evaluation, distinguishing it from similar procedures that do not involve biopsies.
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The procedure represented by CPT® Code 44322 is indicated for patients requiring a colostomy or skin level cecostomy, particularly in cases where multiple biopsies are necessary. This may include conditions such as:
The procedure involves several critical steps to ensure proper execution and patient safety. Each step is detailed as follows:
Post-procedure care involves monitoring the patient for any complications related to the stoma and ensuring proper healing of the surgical site. Patients may require education on stoma care and management, including how to change the stomal appliance and recognize signs of infection or other issues. Follow-up appointments are essential to assess the healing process and to evaluate the biopsies obtained during the procedure for any pathological findings.
| Short Descr | COLOSTOMY WITH BIOPSIES | Medium Descr | COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX | Long Descr | Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 72 - Colostomy, temporary and permanent |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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