General Surgery Coding Alert

Question: Which codes are "primary" for add-on code 44139? May I report it with total abdominal colectomy (44150)?

Florida Subscriber

Answer: You may report +44139 (Mobilization [take-down] of splenic flexure performed in conjunction with partial colectomy [list separately in addition to primary procedure]) with any of seven primary codes, according to CPT:

44140  - Colectomy, partial; with anastomosis
44141 - ... with skin level cecostomy or colostomy
44143 - ... with end colostomy and closure of distal segment (Hartmann type procedure)
44144 - ... with resection, with colostomy or ileostomy and creation of mucofistula
44145 - ... with coloproctostomy (low pelvic anastomosis)
44146 - ... with coloproctostomy (low pelvic anastomosis), with colostomy
44147 - ... abdominal and transanal approach. In most cases (including this one), CPT will include a parenthetical reference following the code descriptor that specifies all the primary codes with which you may report an add-on procedure.
 
You may not apply 44139 with any other codes, including 44150 (Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy). The descriptor for 44139 clearly states, "in conjunction with partial colectomy," whereas 44150 describes a total colectomy.