CPT 44144 Colon Resection Reimbursement | OpenPayer

Summary & Overview

CPT 44144: Colon Resection with Colostomy and Mucous Fistula

CPT code 44144 represents a major abdominal surgical procedure: removal of an affected portion of the colon with exteriorization of the proximal colon as a colostomy and creation of a separate mucous fistula for the distal segment. This operation is clinically significant for management of obstructive, perforated, ischemic, or otherwise nonviable colonic disease and frequently results in inpatient surgical admission with postoperative care needs. Nationally, this code captures complex colorectal resections that have implications for surgical resource use, length of stay, and bundled payment arrangements. Key payers referenced in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for 44144, typical sites of service, and payer coverage context. The publication outlines common billing and coding considerations for this procedure and presents benchmark-oriented information where available. It also highlights policy-relevant factors that affect reimbursement and utilization without providing clinical recommendations. Data not available in the input will be identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44144colon resectioncolostomymucous fistulainpatient surgerygeneral surgerysurgical billingoperative procedure

Billing Code Overview

CPT code 44144 describes a surgical procedure in which the surgeon removes a diseased segment of the colon and brings the proximal bowel end out to the abdominal skin as a colostomy while creating a separate mucous fistula for the distal segment. This operation typically involves abdominal incisions to resect the affected colon and exteriorize both ends on the abdominal wall.

Service type: Major abdominal resection with colostomy and mucous fistula creation
Typical site of service: Inpatient hospital surgical suite (operating room) with postoperative inpatient care

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old with a sigmoid colon malignancy or severe diverticular disease presenting with obstructive symptoms, sepsis risk, or localized perforation requiring removal of the diseased colonic segment. Preoperative workup includes abdominal imaging (CT abdomen/pelvis), bowel prep as appropriate, anesthesia evaluation, and informed consent for colectomy with end colostomy and mucous fistula. In the operating room under general anesthesia, the surgeon performs a segmental colectomy through an open abdominal incision, resects the affected colon segment, and exteriorizes the proximal colonic end as a matured end colostomy through a separate abdominal wall incision and brings the distal colonic stump as a mucous fistula through a separate skin opening for decompression and mucus drainage. Postoperative workflow includes immediate recovery in PACU, standard postoperative orders (IV antibiotics, VTE prophylaxis, stoma care consult), monitoring for anastomotic leak (not applicable here), stoma maturation assessment, and discharge planning with wound and stoma care education. Typical site of service is an inpatient hospital operating room; service type is an open surgical resection with colostomy formation (major abdominal surgery).

Coding Specifications

Modifier	Description	When to Use
`00`	Reserved/Not used in CPT billing	Data not typically appended; follow payer guidance if required

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

CPT-44155-PROCTOCOLECTOMY-WITH-END-ILEOSTOMY

CPT 44155: Proctocolectomy with End Ileostomy

CPT-44141-COLON-RESECTION-WITH-CECOSTOMY-OR-COLOSTOMY

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

CPT-44100-SMALL-INTESTINE-CAPSULE-BIOPSY

CPT 44100: Small Intestine Biopsy via Oral Capsule

CPT-44151-TOTAL-COLECTOMY-ILEAL-POUCH-CONTINENT-ILEOSTOMY

CPT 44151: Total Colectomy with Ileal Pouch and Continent Ileostomy

CPT-44136-SMALL-BOWEL-RECONSTRUCTION-LIVING-DONOR-INTESTINE

CPT 44136: Small Bowel Reconstruction Using Living-Donor Intestine

CPT-44133-LIVING-DONOR-INTESTINAL-HARVEST-WITH-ANASTOMOSIS

CPT 44133: Living-Donor Intestinal Harvest with Primary Anastomosis

CPT-44125-SMALL-INTESTINE-RESECTION-WITH-STOMA-CREATION

CPT 44125: Small Intestine Resection with Stoma Creation

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

CPT 44140: Partial Colectomy with Primary Anastomosis

CPT-44150-TOTAL-COLECTOMY-ILEOSTOMY-OR-ILEORECTAL-ANASTOMOSIS

CPT 44150: Total Colectomy with Ileostomy or Ileorectal Anastomosis

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Taxonomy Code	Specialty	Notes
`408600000X`	Colon & Rectal Surgery (Colorectal Surgery)	Primary specialty performing segmental colectomy with colostomy formation
`207L00000X`	General Surgery	Common performing specialty for open colectomy and colostomy creation
`2080S0001X`	Surgical Oncology	Involved when malignancy is the indication for resection and stoma formation
`208600000X`	Acute Care Surgery	Involved in emergency resections for perforation, obstruction, or sepsis
`174400000X`	Anesthesiology	Provides general anesthesia for the procedure

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K57.20`	Diverticulitis of large intestine without perforation or abscess	Segmental colectomy with colostomy may be indicated for complicated diverticulitis or when primary anastomosis is unsafe
`K63.5`	Polyp of colon	Large or unresectable polyps with malignant potential may prompt segmental resection and colostomy in selected cases
`C18.9`	Malignant neoplasm of colon, unspecified	Colon cancer requiring resection and diversion when primary anastomosis is not feasible or in an emergent setting
`K35.80`	Acute appendicitis with perforation and abscess (example severe intra-abdominal infection)	Severe intra-abdominal infection or contiguous disease process can necessitate resection and diversion (context-specific)
`K65.0`	Acute peritonitis	Peritonitis from perforated colon may require segmental resection and creation of colostomy and mucous fistula
`K63.1`	Ileus	Severe bowel dysmotility or obstruction may lead to resection and diversion if conservative management fails
`K91.89`	Other postprocedural complications and disorders of the digestive system	Used for postoperative complications requiring additional interventions related to `44144`

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44140`	Colectomy, partial; with anastomosis	Alternative partial colectomy where primary anastomosis is performed instead of diversion; may be considered when anatomy and patient condition permit
`44145`	Colectomy, partial; with end colostomy (separate procedure)	Closely related code for partial colectomy resulting in end colostomy — differs by specific surgical technique and documentation details
`44204`	Laparoscopy, surgical, colectomy, partial, with colostomy	Laparoscopic approach to partial colectomy with colostomy creation; used when minimally invasive technique employed instead of open `44144`
`49560`	Repair of stoma, localized	May be performed postoperatively for stoma complications such as retraction, necrosis, or parastomal hernia repair as related follow-up procedures
`45378`	Colonoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing	Preoperative or postoperative endoscopic evaluation related to diagnosis, staging, or surveillance when clinically indicated
`99238`	Hospital discharge day management; 30 minutes or less	Common E/M service used for discharge of patients after inpatient surgical stays including `44144`

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