Coding a Diverting Ileostomy with a Low Anterior Resection/Low Pelvic Anastomosis Partial Colectomy

Question:

Instead of a colostomy as described in the laparoscopic CPT codes 44208 or the open code, 44146, my doctor does a diverting ileostomy. We have been billing the primary codes 44145 or 44207 and adding the ileostomy code, 44187 if laparoscopic or 44310 if open. Is that correct?

Answer:

Partial colectomy with anastomosis and colostomy (codes 44146, open or 44208, laparoscopic) includes creation of a colostomy (stoma of the large intestine) or ileostomy (stoma of the small intestine). The clinical description of this code, written when the code was developed, describes either external opening, so the codes are valued to include either an ileostomy or colostomy. So the correct coding is 44146 or 44208 when a low anterior resection/low pelvic anastomosis partial colectomy and a diverting ileostomy is performed instead of a colostomy.

For more information on colorectal coding, take a look at the KZA webinarColorectal Surgery Coding and Reimbursement, or contact us for more information.

*This response is based on the best information available as of 6/11/20.