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2025 CPT code 44055

Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (e.g., Ladd procedure).

Modifier 63 is exempt for this code.

Modifiers applicable to this code include 22 (Increased Procedural Services), 47 (Anesthesia by Surgeon), 51 (Multiple Procedures) and others as supported by the payer guidelines. Consult a comprehensive modifier list for accurate reporting.

Medical necessity is established by the presence of intestinal malrotation causing symptoms like volvulus, obstruction, or chronic abdominal pain. Supporting documentation, such as imaging studies and clinical findings, is crucial.

The surgeon prepares the patient, administers anesthesia, makes the abdominal incision, explores the intestine for volvulus, straightens the bowel manually (without resection if midgut volvulus is present), mobilizes the duodenum, dissects adhesions, may perform reduction and/or lysis of bands, irrigates the cavity, controls bleeding, and closes the incision.

IMPORTANT:Do not report modifier 63 in conjunction with 44055. Use 44050 if the provider performs reduction of volvulus, intussusception, internal hernia, by laparotomy.

In simple words: The surgeon makes an incision in the abdomen to access and correct a twisted or abnormally rotated intestine. This may involve untwisting the intestine or cutting the tight bands of tissue that are causing the problem. The surgeon then closes the incision with stitches.

This procedure involves an incision to access the affected part of the intestine (excluding the rectum). The surgeon corrects the intestinal malrotation by reducing the volvulus or by dissecting the Ladd’s bands, which are causing the kink in the duodenum. The procedure may involve reduction, lysis, or both. After the procedure, the abdominal cavity is irrigated, bleeding is controlled, and the incision is closed with sutures.

Example 1: A newborn infant presents with bilious vomiting and abdominal distension, diagnosed with midgut volvulus. The surgeon performs a Ladd's procedure to correct the malrotation and prevent further complications., A child experiences chronic abdominal pain and intermittent vomiting. Diagnostic imaging reveals intestinal malrotation with duodenal bands. The surgeon performs a Ladd's procedure to lyse the bands and restore normal intestinal flow., An adult patient presents with acute abdominal pain and signs of bowel obstruction. Imaging reveals intestinal malrotation with volvulus. The surgeon performs a Ladd's procedure to reduce the volvulus and address the malrotation.

Documentation should include operative report detailing the findings, procedures performed (lysis of bands, reduction of volvulus), pre- and post-operative diagnoses, and any complications encountered.

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