2025 CPT code 44799
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Unlisted procedure, small intestine.Used for procedures on the intestine lacking a specific CPT code.
Modifiers may be applicable depending on the circumstances.Consult the CPT codebook for specific modifier rules. Common modifiers might include those indicating multiple procedures (51) or discontinued procedures (53).
Medical necessity for 44799 requires clear documentation demonstrating that the procedure was medically necessary, appropriate, and consistent with the patient's diagnosis and condition.The unusual nature of the procedure needs to be well-documented and justified.
The physician or qualified healthcare professional performing the surgical procedure on the small intestine is responsible for appropriate documentation and coding. They must justify the use of an unlisted code and document the specifics of the procedure accurately.
In simple words: This code is used when a doctor performs a new or unusual surgery on the small intestine that doesn't have a specific billing code.Extra paperwork explaining the surgery is needed to get paid.
CPT code 44799, "Unlisted procedure, small intestine," is utilized when no other existing CPT code accurately reflects the performed procedure on the small intestine.This code requires comprehensive documentation detailing the procedure's nature, extent, medical necessity, time, effort, and equipment used to justify billing.The documentation should include a comparison to similar, existing CPT codes to support the chosen billing amount.
Example 1: A patient presents with a rare, complex intestinal stricture requiring a novel surgical technique not captured by existing CPT codes.The surgeon uses 44799, providing detailed operative notes comparing the procedure to similar, coded procedures and explaining the rationale for the new approach., A surgeon performs a laparoscopic resection of a small bowel tumor with unusual anatomical characteristics, necessitating a modified surgical approach.Code 44799 is used, along with supporting documentation describing the procedure's specifics and justifying its complexity., A patient with Crohn's disease develops an unusual fistula requiring a specialized surgical repair.The surgeon uses 44799 and submits comprehensive documentation, including preoperative imaging, operative notes, and postoperative recovery details, to support the claim.
* Detailed operative report describing the procedure performed.* Preoperative and postoperative diagnoses and findings.* Detailed explanation of why no other CPT code accurately reflects the procedure.* Comparison to similar CPT codes with justifications for differences.* Documentation of time, effort, and resources required for the procedure.* Supporting clinical records, including imaging, pathology reports, etc.
** When using 44799, it is essential to submit a cover letter with the claim, explaining the reason for using this unlisted code and providing detailed supporting documentation.This is critical for successful claim processing and reimbursement.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: The RVUs for 44799 vary significantly depending on the specific procedure performed and the payer.Documentation justifying the complexity and time required is crucial for proper reimbursement.Consult the AMA CPT codebook and payer-specific guidelines for RVU calculations.
- Global Days: The global period for 44799 is determined by the specific procedure performed and the complexity involved.It's crucial to consult CPT guidelines and payer-specific policies.
- Payment Status: Active
- Modifier TC rule: The applicability of a TC modifier depends on whether the service is performed in a facility or by a physician.Refer to the payer's guidelines.
- Fee Schedule: Historical fee schedules for 44799 vary greatly depending on the specific procedure and the payer.There is no single historical fee schedule. Documentation supporting the complexity and time involved is vital for reimbursement.
- Specialties:General Surgery, Colorectal Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center