CPT 44143 Colon Resection Reimbursement | OpenPayer

Summary & Overview

CPT 44143: Colon Resection with End Colostomy

Headline: CPT code 44143: Colon resection with end colostomy — operative code for removal of diseased colon and colostomy formation

CPT code 44143 represents a colon resection in which the diseased segment is excised, the distal colon is stapled and left in the abdomen, and the proximal colon is brought to the skin as an end colostomy. This operative code is nationally significant because it captures care for patients with obstructive, ischemic, inflammatory, or neoplastic colon disease that requires diversion and definitive resection. It is commonly reported for major abdominal surgery performed in the operating room with subsequent inpatient recovery.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The content addresses payer coverage patterns and coding considerations relevant to hospitals and surgical practices that bill for major colorectal procedures.

Readers will learn the clinical context for use of CPT code 44143, typical sites of service and procedural setting, and what to expect in terms of billing capture for a colon resection with end colostomy. The publication provides benchmarks and policy updates where available, operational notes on coding capture, and a concise clinical summary to help revenue cycle and clinical teams align documentation with code selection. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare44143CPTcolon resectioncolostomysurgical oncologygeneral surgeryinpatient surgeryoperative procedure

Billing Code Overview

CPT code 44143 describes a surgical procedure in which the surgeon removes the diseased portion of the colon, staples the distal (lower) end and leaves it in the abdomen, and creates a colostomy by bringing the proximal (upper) end of the colon out through a separate skin incision. This procedure involves an abdominal incision for colon resection and a separate stoma site on the abdominal wall for colostomy formation.

Service type: Inpatient or outpatient surgical resection with colostomy formation (colon resection with end colostomy)
Typical site of service: Operating room in an acute care hospital; postoperative care occurs in the hospital inpatient unit or ambulatory surgical recovery area

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old with obstructing sigmoid colon cancer who presents with progressive abdominal pain, distention, and obstipation. Imaging shows a distal colonic obstruction with proximal dilation and concern for impending perforation. The surgical team admits the patient for urgent exploratory laparotomy. Intraoperative findings include a diseased segment of sigmoid colon with tumor and compromised distal bowel. The surgeon performs a segmental colectomy with exteriorization of the proximal colon as an end colostomy and stapling and leaving the distal rectosigmoid stump in the abdomen (end colostomy, Hartmann-type). The procedure is performed in the main operating room under general anesthesia. Typical workflow includes preoperative consent, anesthesia evaluation, prophylactic antibiotics, the resection and colostomy creation, postoperative recovery in PACU, and inpatient surgical ward care with ostomy education and discharge planning. Common payors encountered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier — standard claim submission	Use for routine reporting when no modifier applies

| 11 | Primary procedure | Report when this colostomy resection is the primary service of the encounter |

| | Increased procedural services | Use when work, time, or complexity substantially exceeds usual for |

CPT 44150: Total Colectomy with Ileostomy or Ileorectal Anastomosis

CPT-44130-INTESTINAL-ANASTOMOSIS-BOWEL-RESECTION-ANASTOMOSIS

CPT 44130: Intestinal Anastomosis, With or Without Stoma

CPT-44120-SMALL-INTESTINE-RESECTION-PRIMARY-ANASTOMOSIS

CPT 44120: Small Intestine Resection with Primary Anastomosis

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

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

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

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

CPT-44144-COLON-RESECTION-WITH-COLOSTOMY-AND-MUCOUS-FISTULA

CPT 44144: Colon Resection with Colostomy and Mucous Fistula

CPT-44147-COLON-RESECTION-OPEN-ABDOMINAL-AND-ANAL-APPROACH

CPT 44147: Colon Resection, Open Abdominal and Anal Approach

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

CPT 44140: Partial Colectomy with Primary Anastomosis

CPT-44145-PARTIAL-COLECTOMY-COLORECTAL-ANASTOMOSIS

CPT 44145: Partial Colectomy with Colorectal Anastomosis

CPT-44127-SMALL-BOWEL-RESECTION-ANASTOMOSIS-INTESTINAL-ATRESIA

CPT 44127: Small-Bowel Resection with Anastomosis for Intestinal Atresia

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44143

Taxonomy Code	Specialty	Notes
`408600000X`	General Surgery	Most common specialty performing colectomy with colostomy creation

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C18.7`	Malignant neoplasm of sigmoid colon	Common indication for sigmoid resection with end colostomy when primary anastomosis is unsafe

| K56.6 | Other and unspecified intestinal obstruction | Indicates obstructing lesion or severe obstruction prompting urgent colectomy with colostomy |

| K63.1 | Perforation of intestine (nontraumatic) | Perforation with contamination may necessitate resection and diversion with colostomy |

| K57.3 | Diverticulitis of large intestine with perforation and abscess | Complicated diverticulitis often managed with resection and diversion (Hartmann procedure) |

| K62.5 | Hemorrhage of rectum and anus | Severe, uncontrolled lower GI bleeding occasionally requires segmental colectomy and diversion |

| C19 | Malignant neoplasm of rectosigmoid junction | Tumors at the rectosigmoid may require resection and colostomy depending on location and contamination |

| Z48.815 | Encounter for surgical aftercare following surgery on the digestive system | Used for postoperative follow-up visits related to the colostomy and colectomy |

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44140`	Colectomy, partial; with anastomosis	Alternative when primary anastomosis is performed instead of colostomy; often considered intraoperatively if conditions permit

| 44141 | Colectomy, partial; with coloproctostomy (low pelvic anastomosis) | Related for low pelvic resections where a primary colorectal anastomosis is created rather than an end colostomy |

| 44145 | Colectomy, partial; total abdominal colectomy, with ileostomy or ileoproctostomy | Performed when disease necessitates more extensive resection and creation of an ileostomy rather than colostomy |

| 49560 | Repair of parastomal hernia | May be performed later if patient develops a parastomal hernia at the colostomy site |

| 44320 | Colostomy closure, takedown of colostomy | Represents the reversal procedure when the distal stump and patient condition allow restoration of continuity |

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