General Surgery Coding Alert

Question: The surgical note says that the surgeon performed a laparoscopic "partial cecectomy," which involved stapling across the cecum. How should we code the procedure?

Ohio Subscriber

Answer: You should use a laparoscopic partial colectomy code, because the cecum is a part of the colon. Based on the description of "stapling across the cecum," the best code choice is probably 44204 (Laparoscopy, surgical; colectomy, partial, with anastomosis), unless the full op report provides additional information about the connection.

CPT® provides several codes for laparoscopic partial colectomy based on how the surgeon connects the ends of the resected bowel -- by creating a colostomy, or an anastomosis, or an ileocolostomy, etc. In addition to 44204, you might consider one of the following codes if the surgical note describes any additional work:

• 44206 -- ... colectomy, partial, with end colostomy and closure of distal segment (Hartmann type procedure)
• 44207 -- ... colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
• 44208 -- ... colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy.