2025 CPT code 44050
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Reduction of volvulus, intussusception, or internal hernia of the intestine (excluding the rectum) via laparotomy.
Modifiers may apply depending on the circumstances of the procedure.For example, modifier 51 (multiple procedures) could be used if multiple procedures are performed during the same surgical session.Consult current modifier guidelines for appropriate use.
Medical necessity for this procedure is established when a patient presents with clinical findings consistent with intestinal obstruction (e.g., volvulus, intussusception, internal hernia), necessitating surgical intervention to alleviate the obstruction and prevent complications such as bowel necrosis or perforation.Documentation must support the diagnosis and the need for surgical repair.
The clinical responsibility for this procedure lies with the surgeon. This involves pre-operative assessment, surgical planning, performing the laparotomy, reducing the intestinal obstruction, achieving hemostasis, and closing the incision. Post-operative care may also be the surgeon's responsibility depending on the facility and payer guidelines. Anesthesiology services would also be necessary.
In simple words: This code describes surgery to fix a twisted, telescoped, or herniated part of the intestine (not including the rectum). The surgeon makes an incision in the abdomen, untwists or fixes the problem, stops any bleeding, and closes the incision.
This CPT code encompasses the surgical reduction of volvulus, intussusception, or internal hernia affecting a portion of the intestine, excluding the rectum.The procedure involves a laparotomy (surgical incision of the abdomen), exploration of the affected intestinal segment, division of any adhesions, manual reduction of the bowel obstruction (twisting, telescoping, or herniation), hemostasis (control of bleeding), and layered closure of the incision.This code does not apply to rectal procedures.
Example 1: A 60-year-old male presents with acute abdominal pain, nausea, and vomiting.Diagnostic imaging reveals a volvulus of the sigmoid colon.A laparotomy is performed, the volvulus is reduced, and the bowel is resected and anastamosed., A 2-year-old female is brought to the ER with symptoms of intussusception (telescoping of the bowel).An exploratory laparotomy reveals an intussusception in the ileum. Manual reduction of the intussusception is successfully performed., A 45-year-old female undergoes a laparotomy for an internal hernia.During the procedure, the surgeon identifies and reduces the herniated bowel, ensuring there are no perforations or other complications. Post op care includes close monitoring of bowel function.
* Complete history and physical examination documenting the patient's symptoms and findings.* Preoperative diagnostic imaging (e.g., X-ray, CT scan) clearly showing the location and nature of the intestinal obstruction.* Operative report detailing the surgical approach, findings, and steps taken during the procedure, including the type of obstruction reduced (volvulus, intussusception, or internal hernia).* Intraoperative photographs or videos (if available).* Pathology report, if any tissue was removed.* Postoperative notes and progress reports.* Medical necessity documentation explaining the reasons for the surgery.
** This code should only be used when the procedure is performed via laparotomy.If the procedure is performed using a minimally invasive approach (e.g., laparoscopy), a different code would be applicable. Always ensure accurate documentation to support the selection of this code.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: This information requires access to specific payer fee schedules and may vary based on location, facility type (inpatient vs. outpatient), and other factors.Consult the appropriate fee schedule for accurate RVU data.
- Global Days: The global period for this procedure will vary depending on payer and individual circumstances.Refer to the specific payer's guidelines for details.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier is dependent on the specific service provided and the billing entity.Consult with your local Medicare Administrative Contractor (MAC) for clarification.
- Fee Schedule: Historical fee schedule data for this code can be obtained from various sources such as the CMS website or private payer fee schedules.This information can change frequently, so always refer to the most up-to-date resources.
- Specialties:General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center