Summary & Overview
CPT 44160: Open Resection of Terminal Ileum and Proximal Colon with Anastomosis
CPT code 44160 represents an open surgical resection of the terminal ileum and proximal colon with anastomosis. This code is used to capture major abdominal bowel surgery where both small and large bowel segments are removed and reconnected. It is clinically significant because these procedures are central to management of conditions such as Crohn disease, neoplasm, ischemia, and traumatic injury, and they carry substantial implications for hospital resource use, perioperative care, and postoperative recovery.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on clinical context and coding definition, payer coverage considerations, and operational implications for billing and inpatient surgical services. The publication outlines benchmarks and common modifiers where available, summarizes clinical scenarios that commonly generate the code, and highlights areas where policy updates or payer-specific rules may affect claim adjudication.
This summary is intended for coding professionals, surgical administrators, and policy analysts seeking a concise, national-level briefing on the clinical and billing significance of 44160. Data not available in the input is noted where applicable in supporting sections.
Billing Code Overview
CPT code 44160 describes an open resection of the terminal ileum and proximal colon with anastomosis of the two ends. The procedure involves surgical removal of the last portion of the small intestine (terminal ileum) and the first portion of the large intestine (proximal colon) followed by rejoining the intestinal segments.
Service type: Open abdominal resection with intestinal anastomosis
Typical site of service: Inpatient or hospital operating room
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with symptomatic obstruction, ischemia, perforation, recurrent Crohn disease, or neoplasm involving the terminal ileum and cecum. The patient often has abdominal pain, localized peritonitis, fever, nausea, vomiting, and imaging (CT scan) demonstrating pathology of the terminal ileum and proximal colon. After preoperative evaluation, bowel preparation as indicated, and informed consent, the surgical team performs an open ileocecectomy with primary anastomosis of the ileum to the colon under general anesthesia. The intraoperative workflow includes laparotomy incision, mobilization of the terminal ileum and right colon, identification and ligation of mesenteric vessels, resection of the diseased segment, and creation of a hand-sewn or stapled ileocolic anastomosis. Typical postoperative care includes pain control, early ambulation, monitoring for anastomotic leak, return of bowel function, and discharge planning with wound care and follow-up. Typical complications monitored for include anastomotic leak, surgical site infection, ileus, and venous thromboembolism. Typical site of service is an inpatient acute care hospital operating room. Service type is open abdominal small intestine/colon resection with anastomosis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / not otherwise specified | Standard reporting when no specific modifier applies |