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The procedure described by CPT® Code 44700 involves the exclusion of the small intestine from the pelvic cavity using either a mesh or other prosthetic material, or native tissue such as the bladder or omentum. This surgical intervention is primarily performed to protect the small intestine from potential radiation damage during radiation therapy. The process begins with the physician making an incision to open the abdomen, allowing access to the small intestine. Once accessed, the small intestine is carefully mobilized and elevated out of the pelvic cavity to ensure it is positioned away from the radiation field. A piece of mesh is then tailored to fit the specific dimensions required for the procedure. This mesh is placed beneath the small intestine and secured to surrounding anatomical structures with sutures, effectively keeping the intestines elevated and protected during subsequent radiation treatments. In some cases, alternative prosthetic devices may be utilized, such as a soft silicone plastic device that is designed to conform to the shape of the pelvis. This device is filled with saline and contrast material, enabling visualization on radiographic images. Radiographs are taken before each radiation session to confirm that the small intestine remains outside the radiation field. The prosthetic device is retained in place throughout the duration of the radiation therapy and is subsequently removed through a small incision after the device has been drained. Another option for this procedure includes the creation of an omental sling, where an omental flap is fashioned, positioned beneath the small intestine, and secured with sutures to maintain the elevation of the intestines away from the radiation exposure. This comprehensive approach ensures the protection of the small intestine during critical radiation therapy sessions.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 44700 is indicated for patients who require protection of the small intestine from radiation exposure during radiation therapy. The following conditions may warrant this procedure:
The procedure for CPT® Code 44700 involves several critical steps to ensure the effective exclusion of the small intestine from the pelvic cavity:
After the completion of the procedure, patients are monitored for any immediate complications related to the surgical intervention. Post-procedure care includes managing the surgical site and ensuring that the patient is comfortable. Patients may be advised on activity restrictions to promote healing and prevent strain on the surgical area. The prosthetic device, if used, will remain in place throughout the radiation therapy sessions and will be removed after the therapy is completed. Follow-up appointments will be scheduled to assess recovery and to ensure that the small intestine remains protected from radiation exposure during treatment. Additionally, patients may receive instructions on signs of infection or complications that should prompt immediate medical attention.
| Short Descr | SUSPEND BOWEL W/PROSTHESIS | Medium Descr | EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS | Long Descr | Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum) | 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 | 96 - Other OR lower GI therapeutic procedures |
| 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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. |
| 1998-01-01 | Added | First appearance in code book in 1998. |
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