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2025 CPT code 44121

Each additional resection and anastomosis of the small intestine (List separately in addition to code for primary procedure).

Code 44121 is used for each additional resection and anastomosis of the small intestine beyond the initial one reported with 44120. It is important to note that this code is for open procedures. Laparoscopic procedures have different codes.

Modifiers may be applicable to this code to indicate specific circumstances of the procedure. Common modifiers used with surgical codes such as 52 (Reduced services), 53 (Discontinued procedure) and 78 (Return to the operating room for a related procedure during the postoperative period) should be appended if applicable.

Medical necessity for each additional resection and anastomosis must be documented. This may include documentation of the patient’s condition requiring the procedure, such as Crohn's disease, small bowel obstruction, or tumors.

At the same session as the initial small intestine resection and anastomosis, when the patient is appropriately prepped and anesthetized, the provider identifies the target area of the intestine through the abdominal incision. They isolate the additional area(s) of the small intestine and resect one or more additional segments, retaining as much blood supply as possible. They connect the remaining intestinal ends in an end-to-end, end-to-side, or side-to-side manner, depending on the location of the resection. After completion of the procedure, the provider ensures control of bleeding and closes the abdominal incision appropriately.

In simple words: During the same surgery where a section of the small intestine is removed and reconnected, this code covers the removal and reconnection of each additional section of the small intestine.

Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure). (Use 44121 in conjunction with 44120)

Example 1: A patient undergoing surgery for Crohn's disease requires removal of two separate diseased segments of the small intestine. 44120 would be reported for the first resection and anastomosis, and 44121 would be reported for the second., During a laparotomy for small bowel obstruction, the surgeon finds multiple areas of stricture in the small intestine requiring three separate resections and anastomoses. 44120 is reported for the first resection, and 44121 is reported twice for the two additional resections., A patient with multiple small intestine tumors requires resection of three segments. 44120 is reported for the first resection and 44121 is reported twice, once for each additional resection.

Operative report detailing the number and location of small intestine resections and anastomoses performed, including the reason for the procedure, findings, and techniques used.

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