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2025 CPT code 44111

Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies.

Code 44111 is reported for each distinct lesion excised requiring a separate enterotomy. It should not be used for procedures requiring anastomosis, exteriorization, or fistulization.

Modifiers may be applicable. For example, modifier -22 might be used for increased procedural services.

Medical necessity must be established by documenting the patient's symptoms, the diagnosis justifying the procedure (e.g., polyps, tumors, bleeding), and the clinical rationale for excising the lesions. Justification should support that less invasive procedures are not an option.

The surgeon is responsible for the entire procedure, from prepping and anesthetizing the patient to making incisions, excising lesions, closing the enterotomy/colotomy, controlling bleeding, and closing the abdominal incision.

In simple words: The surgeon removes one or more abnormal growths from the small or large intestine through several small cuts.This procedure doesn't require connecting parts of the intestine, creating an opening, or bringing the intestine outside the body. The surgeon makes an incision in the belly, finds the problem area in the intestine, and removes the growths. The cuts in the intestine are then closed, and the belly incision is stitched up.

This procedure involves the excision of one or more lesions from the small or large intestine through multiple incisions. It does not involve creating an anastomosis, fistula, or bringing the intestine through the skin.The surgeon makes an incision in the abdomen, identifies the affected area of the intestine, and isolates the segment containing the lesion(s). Multiple incisions are made to access all target areas. The lesions are excised, and the enterotomy (or colotomy if in the colon) is closed using staples or sutures.Bleeding is controlled, and the abdominal incision is closed.

Example 1: A patient presents with multiple polyps in the sigmoid colon. The surgeon performs a colonoscopy and removes the polyps through multiple enterotomies, closing each one with sutures. Code 44111 is used., A patient has several small tumors in the small intestine. The surgeon makes an abdominal incision, identifies the affected segments of the intestine, and excises the tumors through multiple enterotomies, closing each with staples. Code 44111 is appropriate., A patient with Peutz-Jeghers syndrome has numerous hamartomatous polyps throughout the small intestine. The surgeon removes these polyps via multiple enterotomies during laparotomy. Code 44111 is used.

Documentation should include the location and size of each lesion, the number of enterotomies performed, the method of closure (sutures or staples), and any complications encountered. Operative report must clearly indicate that multiple enterotomies are performed on either small or large intestine.

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