Summary & Overview
CPT 44188: Laparoscopic Colostomy or Skin-Level Cecostomy
CPT code 44188 designates a laparoscopic colostomy or skin-level cecostomy procedure. This surgical code captures minimally invasive creation of a colostomy or skin-level cecostomy and is used in billing for operative services across hospital outpatient departments, ambulatory surgery centers, and inpatient surgical settings. Nationally, procedures captured by this code are relevant to colorectal surgery, management of bowel diversion, and care of patients with obstructive, inflammatory, or traumatic bowel conditions.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides payor-aligned context for coding and coverage, including typical places of service and clinical scenarios where the procedure is billed. Readers will find a concise explanation of the code’s clinical intent, common sites of service, and what to expect from payor coverage frameworks. The piece also outlines where to look for benchmarks, potential policy updates affecting surgical coding, and the clinical context that commonly supports use of the code.
This summary is intended for a national audience of clinicians, coding professionals, and health policy analysts seeking a clear description of CPT code 44188, its clinical application, and the payer landscape relevant to surgical bowel diversion procedures.
Billing Code Overview
CPT code 44188 describes a laparoscopic colostomy or skin-level cecostomy procedure. The code applies when a provider performs creation of a colostomy or a skin-level cecostomy using laparoscopic techniques.
Service Type: Surgical — Minimally Invasive Abdominal Surgery
Typical Site of Service: Operating room or ambulatory surgery center, with postoperative care in the hospital or outpatient recovery area depending on clinical need.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of recurrent sigmoid diverticulitis presents with chronic colonic obstruction and poor bowel function. After evaluation including CT abdomen/pelvis showing distal colonic stricture and failed conservative measures, the colorectal surgery team schedules a laparoscopic colostomy to divert fecal stream and relieve obstruction. The procedure is performed in an operating room under general anesthesia. Preoperative workflow includes informed consent, pre-op antibiotics, bowel preparation as indicated, and anesthesia assessment. Intraoperative steps include laparoscopic mobilization of the colon, creation of a skin-level colostomy with maturation of the stoma at the selected abdominal quadrant, hemostasis, and closure of port sites. Postoperative workflow involves recovery in PACU, stoma care education by enterostomal therapy nursing, pain control, monitoring for complications (bleeding, infection, small-bowel obstruction), and coordination of outpatient ostomy nursing follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when another unrelated procedure or service is performed on the same day that is not normally reported with the colostomy and documentation supports distinct procedural circumstances. |
62 |