General Surgery Coding Alert

Reviewed on May 15, 2015; no changes to content

Question: How should I report colostomy takedown and re-anastomosis? Is the re-anastomosis included in 44340, or should I add a separate code for it?

Answer: You need report only a single code for colostomy takedown with re-anastomosis, but you should choose 44625 (Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal) rather than 44340 (Revision of colostomy; simple [release of superficial scar] [separate procedure]).

Code 44625 describes takedown of the colostomy and the re-approximation of the bowel ends, whereas 44340 describes only takedown of the colostomy. You would use 44625 when an end colostomy is taken down and requires that the surgeon re-establish the continuity of the colon. You should report 44340 when a loop colostomy exists and the surgeon simply takes down the -ostomy and repairs the entry site.