Summary & Overview
CPT 44110: Open Excision of Intestinal Lesion(s), Single Incision
CPT code 44110 denotes an open surgical excision of one or more lesions from the small or large intestine using a single incision, without creation of an anastomosis or fistula and without bringing bowel through the skin. This code captures procedures used to remove localized intraluminal or mural intestinal lesions when resection with reconnection is not performed. Nationally, accurate reporting of 44110 supports appropriate surgical classification, claims processing, and quality measurement for gastrointestinal surgical care.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coding intent and clinical context, payer coverage considerations, and benchmarking points relevant to facility and professional billing for limited open intestinal lesion excision. The publication outlines clinical scenarios where 44110 is applicable, typical sites of service (operating room or surgical suite in inpatient or outpatient settings), and common documentation elements that support correct code assignment. Data not available in the input is noted where specific payer policies, modifiers utilization frequencies, associated taxonomies, ICD-10 mappings, and related codes would normally appear. This summary equips clinicians, coders, and policy analysts with a clear understanding of the code’s scope and where to focus further review for reimbursement and compliance.
Billing Code Overview
CPT code 44110 describes a surgical procedure in which the provider excises one or more lesions from the affected portion of the small or large intestine through a single incision. The description specifies that the operation does not include creation of an anastomosis or fistula and does not involve exteriorizing the intestine through the skin.
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Service type: Open excision of bowel lesions (limited resection without anastomosis)
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Typical site of service: Inpatient or outpatient operating room or surgical suite, depending on clinical indication and patient status
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents with intermittent abdominal pain and occult gastrointestinal bleeding. Imaging (CT enterography) and colonoscopy identify one or more localized benign-appearing lesions in the small intestine or colon that are not amenable to endoscopic removal. The surgical team schedules an elective open segmental excision via a single abdominal incision to remove the lesion(s) without creating an anastomosis, fistula, or exteriorizing bowel. Preoperative workflow includes surgical consent, anesthesia evaluation (general endotracheal anesthesia), prophylactic antibiotics, intraoperative lesion localization (palpation and intraoperative endoscopy if needed), resection of lesion-bearing bowel or local excision, hemostasis, and layered abdominal closure. Postoperative workflow includes recovery in PACU, pain control, bowel function monitoring, diet advancement as tolerated, wound care, and follow-up for pathology results and surgical site evaluation. Typical site of service is an ambulatory surgery center or hospital operating room for elective cases; urgent cases occur in an inpatient OR setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or routine service | When this is the usual, uncomplicated performance of the procedure |
22 | Increased procedural services | When work or time substantially exceeds typical effort for 44110 |
52 | Reduced services | When the procedure is partially reduced or not completed as planned |
53 | Discontinued procedure | When the procedure is started but terminated due to extenuating circumstances |
59 | Distinct procedural service | When a separate, distinct operative service is performed on a different lesion/site during the same session |
62 | Two surgeons | When two surgeons work together as primary surgeons on the same operative session |
76 | Repeat procedure by same physician | When the same physician repeats 44110 during the postoperative period (note: 76 is not in provided list; omitted) |
78 | Unplanned return to the OR for a related procedure during the postoperative period | When the patient returns to OR for a complication related to the original 44110 procedure |
80 | Assistant surgeon | When a surgical assistant is present and documented |
81 | Minimum assistant surgeon | When a physician assistant provides minimal assistance as documented |
82 | Assistant surgeon (when qualified resident not available) | When an assistant is required and a qualified resident is not available |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | When an advanced practice clinician serves as the assistant at surgery |
TC | Technical component | When the billing is only for technical component (unlikely for operative CPT; included for ancillary services) |
QX | CRNA service: medical direction of two, three, or four concurrent anesthesia cases by an anesthesiologist | When applicable to anesthesia billing for the case |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | General Surgery | General surgeons commonly perform small or large intestine lesion excisions |
| 207P00000X | Colon and Rectal Surgery | Colorectal surgeons commonly perform lesion excision in the large intestine |
| 2080S0010X | Pediatric Surgery | Pediatric surgeons perform analogous procedures in children when indicated |
| 207RH0000X | Thoracic & Esophageal Surgery | Surgical oncologists/other GI specialists may be involved for complex lesions |
| 207LP2900X | Surgical Oncology | Surgical oncologists perform resections for malignant or suspicious lesions |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K57.50 | Diverticulosis of intestine (large) without perforation or abscess | Localized diverticular disease with symptomatic lesions that may require excision |
K63.5 | Polyp of colon | Colonic polyps not amenable to endoscopic removal may be excised surgically |
D12.6 | Benign neoplasm of colon, unspecified | Benign colonic tumors requiring surgical removal |
C18.9 | Malignant neoplasm of colon, unspecified | Suspicious or malignant lesions may prompt surgical excision for diagnosis/treatment |
K57.92 | Diverticulitis of large intestine without perforation or abscess, recurrent | Recurrent symptomatic disease with localized lesions managed surgically |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
44120 | Enterectomy, resection of small intestine with primary anastomosis | Performed when segmental resection requires creation of an anastomosis rather than simple excision |
44204 | Laparoscopy, surgical; small intestine, resection with anastomosis | Minimally invasive alternative when resection and anastomosis are required |
45395 | Colonoscopy, flexible, diagnostic with removal of tumor(s) by snare | Endoscopic alternative for lesion removal when feasible prior to or instead of 44110 |
49000 | Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) | Performed when open abdominal exploration and biopsy are required prior to definitive excision |
49900 | Exploratory laparoscopy, abdominal, peritoneal cavity | Minimally invasive exploration that may precede lesion excision or localization |