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2025 CPT code 44155

Colectomy, total, abdominal, with proctectomy; with ileostomy.

Refer to CPT guidelines for proper coding of this procedure and related services. Pay attention to any specific payer guidelines regarding documentation requirements.

Modifiers may be applicable in certain situations, such as increased procedural services (22), or multiple procedures (51). Refer to modifier guidelines.

Medical necessity must be established based on the underlying condition requiring the colectomy. This typically involves documentation of failed medical management, severity of disease, or prophylactic intent in high-risk individuals.

The surgeon performs the procedure, including making the incision, removing the colon and rectum, creating the ileostomy, and closing the incision.

IMPORTANT (For laparoscopic procedure, use 44212)

In simple words: This surgery removes the entire colon and rectum, creating a new opening in the abdomen for waste to exit the body. This new opening is called an ileostomy, and a pouch is worn to collect the waste.

This procedure involves the complete removal of the colon, including the rectum, through an abdominal incision. The terminal ileum (the end of the small intestine) is then brought to the surface of the abdomen to create an ileostomy, an artificial opening for the passage of stool.This is typically performed for conditions such as colorectal cancer, Crohn's disease, or other conditions requiring complete removal of the large intestine.

Example 1: A patient with advanced colorectal cancer requires removal of their entire colon and rectum., A patient with severe Crohn's disease unresponsive to other treatments needs a total colectomy and ileostomy formation., A patient with familial adenomatous polyposis (FAP) undergoes this procedure prophylactically to prevent colon cancer.

Documentation should include operative report detailing the procedure, including the extent of the colectomy, the creation of the ileostomy, any complications, and the diagnosis necessitating the procedure. Preoperative diagnostics like colonoscopy and imaging studies should also be documented.

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