2025 CPT code 44156
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Total abdominal colectomy with proctectomy and continent ileostomy.
Modifiers may apply depending on the circumstances of the procedure and should be used per CPT guidelines. Examples include modifiers for multiple procedures (51), reduced services (52), and other relevant modifiers based on the clinical scenario.
Medical necessity for this procedure is established by the presence of a disease affecting the colon and rectum (e.g., ulcerative colitis, Crohn's disease, familial adenomatous polyposis, or colorectal cancer) that cannot be adequately managed by other means.The procedure should be deemed medically necessary by the physician based on the patient's clinical condition.
The surgeon's responsibility includes prepping the patient, making the necessary incisions, dissecting the surrounding structures, freeing and ligating the colon and rectum, dividing the terminal ileum and upper rectum, removing the colon and rectum, creating the ileal pouch, constructing the continent ileostomy, checking for bleeding, and closing the incision.
In simple words: The surgeon removes the entire large intestine and rectum.They then create a pouch from the end of the small intestine and connect it to the belly, allowing waste to be emptied manually without needing a bag.
This procedure involves the complete surgical removal of the colon and rectum (total abdominal colectomy and proctectomy).A continent ileostomy is then created by surgically forming an ileal pouch from the terminal ileum and connecting it to the abdominal wall, creating an artificial opening for waste elimination that doesn't require an external appliance. The patient empties the pouch manually.
Example 1: A 60-year-old male patient diagnosed with ulcerative colitis requiring total colectomy and proctectomy. A continent ileostomy is created to improve quality of life. , A 70-year-old female patient with familial adenomatous polyposis undergoing a total colectomy and proctectomy with a continent ileostomy.This approach is chosen to prevent colorectal cancer. , A 55-year-old patient with a history of Crohn’s disease requiring a total colectomy, proctectomy, and continent ileostomy due to severe complications. This procedure manages their condition but may not cure it.
* Complete history and physical examination.* Detailed documentation of the surgical procedure, including the technique used for the ileal pouch and continent ileostomy construction.* Preoperative and postoperative imaging (e.g., CT scan, colonoscopy) to demonstrate the extent of disease.* Pathology report confirming the diagnosis (e.g., ulcerative colitis, familial adenomatous polyposis, Crohn's disease, or colorectal cancer).* Documentation of any complications and their management.* Patient's understanding and consent for the procedure and potential risks.
** The provided information focuses on the surgical procedure itself. Postoperative care and potential complications should be coded separately using appropriate codes.Always confirm the payer's specific guidelines and coverage policies before billing.
- Revenue Code: P1B (Major Procedure - Colectomy)
- RVU: This information is not available in the provided text.Consult the current CPT codebook and/or your payer's fee schedule for RVU information.
- Global Days : The global period for this procedure is not specified in the provided text. Consult the current CPT codebook and/or your payer's guidelines for the appropriate global period.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier depends on the specifics of the procedure and the payer. Consult the payer's guidelines for information.
- Fee Schedule : Historical fee schedule data is unavailable in the provided text. Check with your payer for specific historical reimbursement information.
- Specialties:Colorectal Surgery, General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center