CPT 44132 Donor Small-Bowel Reimbursement | OpenPayer

Summary & Overview

CPT 44132: Donor Small Intestine Resection and Cold Preservation

CPT code 44132 captures an open surgical resection of a small intestine segment from a cadaver donor with immediate cold preservation for transplantation. This code documents the donor-side procurement procedure that enables intestinal transplantation, a specialized and resource-intensive component of organ transplant programs. Nationally, accurate coding for donor organ recovery affects transplant supply chain tracking, hospital billing for procurement services, and coordination with organ procurement organizations.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 44132, typical sites of service, commonly associated modifiers, and expected billing considerations. The publication outlines benchmarks and reimbursement patterns where available, summarizes policy updates relevant to transplant procurement coding, and provides operational context for hospital billing teams and transplant program administrators.

This summary serves clinicians, charge masters, and revenue cycle professionals who need a clear, national-level reference for documenting and classifying cadaveric small-bowel procurement and preservation procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44132small bowel procurementorgan transplantationsurgical resectiondonor organ preservationinpatient surgerytransplant billing

Billing Code Overview

CPT code 44132 describes an open resection of a segment of small intestine procured from a cadaver and preserved on ice and in cold preservation solution for transplantation into a recipient. This procedure involves the surgical removal of a donor small-bowel segment with immediate preservation to maintain tissue viability for subsequent transplant.

Service type: Organ procurement and preservation for transplantation
Typical site of service: Operating room / hospital inpatient surgical suite

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a deceased organ donor undergoing multi-organ recovery in an operating room at an organ procurement organization or transplant center. The on-call transplant surgeon performs an open resection of a segment of small intestine intended for transplantation into a recipient. The donor is hemodynamically managed by the recovery team, and organ viability is assessed prior to procurement. The resected intestinal segment is flushed with and preserved in cold preservation solution and stored on ice for transport to the recipient center. Documentation includes donor consent/authorization, donor identification, organ-specific intraoperative findings (vascular anatomy, ischemia time), preservation solution used, cold ischemia start time, surgical technique, personnel present, and chain-of-custody for the recovered organ. Typical site of service is an operating room in a hospital or designated procurement facility. The service type is surgical organ procurement for transplantation.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (placeholder)	Used when no specific CMS modifier applies to the claim.
`22`	Increased procedural services

CPT 44141: Colon Resection with Skin-Level Cecostomy or Colostomy

CPT-44140-PARTIAL-COLECTOMY-WITH-PRIMARY-ANASTOMOSIS

CPT 44140: Partial Colectomy with Primary Anastomosis

CPT-44160-OPEN-RESECTION-TERMINAL-ILEUM-PROXIMAL-COLON-ANASTOMOSIS

CPT 44160: Open Resection of Terminal Ileum and Proximal Colon with Anastomosis

CPT-44145-PARTIAL-COLECTOMY-COLORECTAL-ANASTOMOSIS

CPT 44145: Partial Colectomy with Colorectal Anastomosis

CPT-44110-OPEN-EXCISION-INTESTINAL-LESION-SINGLE-INCISION

CPT 44110: Open Excision of Intestinal Lesion(s), Single Incision

CPT-44137-SMALL-INTESTINE-GRAFT-EXPLANTATION

CPT 44137: Small Intestine Graft Explantation

CPT-44139-SPLENIC-FLEXURE-MOBILIZATION-DURING-COLECTOMY

CPT 44139: Splenic Flexure Mobilization During Colectomy

CPT-44126-SMALL-BOWEL-RESECTION-CONGENITAL-ATRESIA-END-TO-END-ANASTOMOSIS

CPT 44126: Small Bowel Resection for Congenital Atresia with End-to-End Anastomosis

CPT-44121-ADDITIONAL-SMALL-INTESTINE-RESECTION-ANASTOMOSIS

CPT 44121: Additional Small Intestine Resection with Anastomosis

CPT-44100-SMALL-INTESTINE-CAPSULE-BIOPSY

CPT 44100: Small Intestine Biopsy via Oral Capsule

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Taxonomy Code	Specialty	Notes
2080P0206X	Transplant Surgeon	Surgeons specializing in abdominal organ transplantation and procurement.
208000000X	General Surgery	General/acute care surgeons who participate in organ recovery teams.
208000000X-T2	Trauma Surgery (or Acute Care Surgery)	Surgeons experienced in complex retrievals in urgent settings.
208600000X	Surgery, Colon & Rectal	May participate when intestinal anatomy or pathology requires subspecialty input.
2084P0800X	Surgical Critical Care	Providers involved in donor management and perioperative critical care.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`49720`	Donor hepatectomy, including cold preservation for transplant	Often performed during multi-organ recovery with coordinated timing and shared preservation logistics.
`48550`	Intestinal resection and anastomosis, small intestine; single resection and anastomosis	Represents therapeutic resection in recipients or donor anatomy reference; not a procurement-specific code but related anatomic procedure.
`38206`	Blood-derived hematopoietic progenitor cell harvesting for transplantation; marrow aspiration from donor	Example of another donor procurement procedure performed in transplant workflows (different tissue type) and billing conventions.
`50300`	Donor nephrectomy, open, including cold preservation for transplant	Common concurrent organ procurement procedure that shares operative team and transport coordination.
`00562`	Anesthesia for open abdominal procedures for organ retrieval or transplant	Anesthesia services commonly billed in conjunction with open organ procurement procedures.

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