Summary & Overview
CPT 44145: Partial Colectomy with Colorectal Anastomosis
CPT code 44145 represents a partial colectomy with colorectal anastomosis — surgical removal of a portion of the colon followed by reconnection of the remaining colon to the rectum to restore continuity. This procedure is a key operative option for malignant and benign colorectal disease and carries significant implications for surgical quality metrics, inpatient resource use, and reimbursement for major abdominal surgery. Nationally, utilization and payment policies for colorectal resection influence hospital surgical volumes, perioperative care pathways, and bundled payment considerations.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what CPT code 44145 represents, the clinical context for use, and the typical site of service. The publication summarizes payer coverage patterns and common modifiers used with the code where available, and highlights benchmarks and policy updates relevant to colorectal surgical services. Sections cover clinical indications, coding considerations, and payer-specific policy themes to help coding, billing, and revenue teams understand how CPT code 44145 is applied in practice. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 44145 describes a surgical procedure in which the provider removes a portion of the colon (partial colectomy) and connects the end of the remaining colon to the rectum to restore bowel continuity. This procedure is a form of colorectal resection performed for conditions that require removal of diseased or damaged colon segments.
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Service type: Surgical resection and anastomosis of the colon (partial colectomy with colorectal anastomosis)
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Typical site of service: Hospital operating room or inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old adult with symptomatic left-sided colon pathology such as a segmental colon cancer, complicated diverticulitis with stricture, or ischemic colitis localized to the sigmoid or descending colon. The patient presents with abdominal pain, change in bowel habits, possible bleeding, and CT or colonoscopy findings confirming a diseased segment requiring resection. After preoperative evaluation (history, physical, labs, anesthesia assessment), the patient is taken to an operating room in an acute care hospital or ambulatory surgery center equipped for major abdominal surgery. The surgeon performs a segmental colectomy removing the diseased portion of colon and performs a colorectal anastomosis connecting the proximal colon end to the rectum to restore intestinal continuity. Intraoperative tasks include mobilization of the colon, vascular control, segmental resection, specimen extraction, anastomotic technique (hand-sewn or stapled), leak test as indicated, and hemostasis. Postoperative workflow includes recovery in PACU, inpatient monitoring for ileus, anastomotic leak, infection, pain control, early ambulation, bowel function assessment, and discharge planning with follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Standard billing indicator (no modifier) | Use when no specific modifier applies and service is billed normally |
11 | Primary surgeon | Use to indicate the surgeon acted as the primary surgeon when required by payer rules |
22 | Increased procedural services | Use when documentation supports substantially greater work than typical for the procedure |
52 | Reduced services | Use when a portion of the procedure is not performed or a staged/limited procedure occurred |
53 | Discontinued procedure | Use when procedure was started but terminated due to extenuating circumstances prior to completion |
54 | Surgical care only | Use when billing only the surgical component, e.g., another provider bills pre/postoperative care |
55 | Postoperative management only | Use when billing only the global postoperative care portion |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure |
66 | Surgical team | Use when a surgical team approach is reported per payer requirements |
78 | Unplanned return to OR | Use for related return to operating room during the postoperative period for a related procedure |
79 | Unrelated procedure or service | Use when a separate, unrelated procedure is performed during the global period |
80 | Assistant surgeon | Use when an assistant surgeon participates and the payer requires the assistant modifier |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist | Use when an eligible non-physician practitioner performs part or all of the procedure as allowed by state law and payer policy |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Colon and Rectal Surgery | Specialists who commonly perform segmental colectomy with colorectal anastomosis |
2080P0206X | General Surgery | General surgeons frequently perform colectomies for neoplasm, diverticular disease, or ischemia |
2086S0122X | Surgical Oncology | Surgical oncologists perform colectomy for colorectal malignancy and complex resections |
208D00000X | Acute Care Surgery | Acute care/trauma surgeons perform emergent colectomy for perforation or ischemia |
363L00000X | Gastroenterology (consultative role) | Gastroenterologists perform diagnostic workup (colonoscopy) and perioperative evaluation |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C18.7 | Malignant neoplasm of sigmoid colon | Segmental colectomy with colorectal anastomosis is commonly performed for sigmoid colon cancer requiring resection and restoration of continuity |
K57.32 | Diverticulitis of large intestine with perforation and abscess, sigmoid colon | Complicated diverticulitis with perforation/abscess often necessitates resection and anastomosis or staged operations |
K55.1 | Chronic mesenteric ischemia | Ischemic segments of colon may require resection with anastomosis when viable margins allow |
K63.5 | Polyp of colon | Large or unresectable polyps may require segmental colectomy for definitive management |
K56.6 | Other and unspecified intestinal obstructions | Obstruction from strictures or tumors sometimes requires segmental colectomy and anastomosis |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
44140 | Colectomy, partial; with anastomosis (e.g., ileocolic, colocolic) | Similar partial colectomy codes for resections of other colon segments; selected when anatomy differs from colon-to-rectum anastomosis |
44146 | Colectomy, partial; with coloproctostomy (low pelvic anastomosis) | Used for low colorectal anastomoses; may be selected for resections requiring a very low rectal anastomosis |
44160 | Colectomy, partial; with colostomy or ileostomy, with closure of other end (e.g., Hartmann reversal) | Performed when diversion or stoma creation is required instead of immediate anastomosis or when reversal of diversion follows |
44204 | Laparoscopy, surgical; colectomy, partial, with anastomosis | Laparoscopic approach equivalent when the procedure is performed minimally invasively |
49420 | Removal of temporary transanal rectal tube or other rectal decompression device | Ancillary procedures performed in perioperative management or in complication care |
G0399 | Unlisted procedure, hospital outpatient department | Used only when no specific code fits a complex or extended colon procedure variant in outpatient setting |