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2025 CPT code 44050

Reduction of volvulus, intussusception, or internal hernia of the intestine (excluding the rectum) via laparotomy.

Adhere to all current CPT coding guidelines, including those related to surgical procedures and laparotomies.Ensure the code accurately reflects the extent and nature of the services performed.

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.

IMPORTANT:Use 44055 for correction of malrotation by lysis of duodenal bands or reduction of midgut volvulus.

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.

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