2025 CPT code 44135
(Active) Effective Date: N/A Revision Date: N/A Surgery - Intestinal Transplantation Excision Procedures on the Intestines (Except Rectum) Feed
Intestinal allotransplantation from a cadaver donor.
Modifiers may be applicable depending on the specifics of the case, such as the use of assistants (modifiers 80, 81, AS), the extent of services provided (modifier 52), or additional procedures (modifier 59).Consult the current modifier guidelines.
Medical necessity will be determined by payer guidelines and must be supported by clinical documentation demonstrating the patient's medical condition warrants the transplantation procedure. Documentation must highlight that the patient's life or health is at significant risk without the transplant.This may involve failed attempts of less-invasive treatments or irreversible damage.
The clinical responsibility includes pre-operative evaluation and assessment of the patient, harvesting the intestinal allograft from the donor (if not already done), preparation and preservation of the allograft, performing the transplantation procedure, and providing post-operative care, monitoring, and management of the patient. This may involve a surgical team, including surgeons, assistants, and anesthesiologists.
In simple words: This surgery replaces a damaged section of the patient's small intestine with a healthy section from a deceased donor.The donor's intestine is prepared, preserved, and then connected to the patient's intestine. The patient receives ongoing care after the surgery.
This procedure involves the transplantation of intestinal allograft from a deceased donor to a recipient.The procedure includes harvesting the intestine graft from the donor, cold preservation of the graft, preparation of the allograft (which may include mobilization and fashioning of the superior mesenteric artery and vein, and additional reconstruction such as venous and/or arterial anastomoses), transplantation of the allograft into the recipient, and post-operative care of the recipient.Recipient enterectomy may or may not be performed as part of this procedure.
Example 1: A 45-year-old patient with Crohn's disease requiring extensive resection of the small bowel undergoes intestinal transplantation from a cadaveric donor. Code 44135 is billed for the recipient procedure., A 22-year-old patient with short bowel syndrome and severe malnutrition receives an intestinal transplant from a deceased donor.The procedure involves significant backbench work to reconstruct the mesenteric vessels. Code 44135, along with other appropriate codes as per the performed procedures, is billed., A 10-year-old patient with necrotizing enterocolitis undergoes a small bowel transplant from a deceased donor.The surgeon performs the transplant and the case requires significant post-operative care due to complications. Code 44135 is billed along with appropriate codes for additional procedures and post-operative care.
Complete and detailed operative report, including specifics of the donor enterectomy, allograft preparation and reconstruction, recipient enterectomy (if performed), transplantation details, and post-operative care.Pre-operative diagnostic studies demonstrating medical necessity, such as imaging studies, pathology reports, and assessment of organ function.Documentation supporting the need for transplant and appropriate post-operative care protocols.All relevant clinical notes and hospital records.
** This code may be used in conjunction with other CPT codes for donor enterectomy (44132, 44133), associated backbench work (44715, 44720-44721), and any additional procedures performed as part of the overall transplantation process.The need for additional codes may depend on the complexity of the case. Always consult with the physician and refer to payer-specific guidelines for accurate coding.
- Revenue Code: May vary depending on payer and facility. Consult payer-specific guidelines.
- RVU: The RVUs for this code will vary based on geographic location and other factors. Consult the appropriate fee schedule for specific RVU values.
- Global Days: The global period for this procedure is usually extensive and will be determined by payer policy and specific circumstances of the case. It may include pre-operative, intra-operative, and post-operative care for a significant period of time.
- Payment Status: Active
- Modifier TC rule: TC modifier may not be directly applicable to this code as the procedure represents a single entity of service.
- Fee Schedule: Fee schedules vary by payer and location. Historical data on fee schedules can be accessed through payer-specific resources or by searching for historic CPT code data using reputable medical billing databases.
- Specialties:Surgical Gastroenterology, Transplant Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center