CPT 44238 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 44238: Laparoscopic Intestinal Procedure, Unspecified

CPT code 44238 designates laparoscopic procedures on the intestine, excluding the rectum, when no specific CPT code applies. It is used to capture minimally invasive intestinal surgeries that do not fit other code descriptions. Nationally, this code matters because it provides a billing pathway for diverse laparoscopic intestinal interventions that lack a dedicated code, supporting consistent claims submission for hospitals and surgical centers.

Key payers included in coverage and benchmarking discussions are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of code usage context, payer coverage considerations, typical sites of service, and common modifiers associated with reporting this code. The publication also summarizes expected clinical scenarios in which 44238 is used and highlights areas where claims reviewers and revenue cycle teams commonly apply additional documentation scrutiny.

This summary prepares clinical coders, billing specialists, and policy analysts to understand where 44238 fits in surgical coding workflows, what to expect from major payers, and which aspects of documentation and service setting are most relevant when this nonspecific laparoscopic intestinal procedure code is reported.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare44238CPTlaparoscopic surgeryintestinal surgerysurgical codinghospital outpatientambulatory surgeryprocedure coding

Billing Code Overview

CPT code 44238 reports laparoscopic procedures on the intestine, excluding the rectum, when no more specific code exists. This code applies to minimally invasive surgical operations involving the small or large intestine (not including rectal procedures) performed via laparoscopy.

Service type: Laparoscopic intestinal surgery
Typical site of service: Ambulatory surgical center or inpatient/outpatient hospital surgical setting

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient presents with progressive crampy abdominal pain, bloating, and intermittent obstructive symptoms after prior abdominal surgery. Imaging demonstrates a segmental small bowel obstruction with a transition point and adhesions suspected. The surgical team schedules a minimally invasive operative exploration and lysis of adhesions with possible small bowel resection using laparoscopy. Intraoperative findings may include dense adhesive disease or a compromised intestinal segment requiring resection and anastomosis. The typical workflow includes preoperative evaluation and consent, general anesthesia, laparoscopic access and diagnostic survey of the peritoneal cavity, adhesiolysis or resection of the affected intestinal segment (excluding rectum), hemostasis, possible intracorporeal or extracorporeal anastomosis, and closure. Postoperative care includes monitoring for return of bowel function, pain control, and discharge planning. This laparoscopic intestinal procedure is reported using 44238 when no specific laparoscopic intestinal procedure code applies.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than usual (document justification).

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Taxonomy Code	Specialty	Notes
208000000X	General Surgery	Most common specialty performing laparoscopic small bowel procedures.
208600000X	Colon and Rectal Surgery	May perform complex intestinal resections, though `44238` excludes rectum-specific codes.
207Q00000X	Obstetrics & Gynecology	Occasionally involved when gynecologic pathology or adhesions are addressed in conjunction with intestinal work.
2084P0800X	Surgical Critical Care	May be involved for critically ill surgical patients requiring operative management.
367A00000X	Physician Assistant	Often assists in perioperative and operative care under surgeon supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K56.60`	Unspecified intestinal obstruction	Common indication for laparoscopic exploration and adhesiolysis or resection.
`K56.69`	Other intestinal obstruction	Covers other mechanical obstructions prompting laparoscopic intervention.
`K57.20`	Diverticulosis of small intestine without perforation or abscess	May require surgical management if complicated and involving small bowel segments.
`K55.9`	Vascular insufficiency of intestine, unspecified	Mesenteric ischemia or chronic ischemia may necessitate resection of nonviable bowel.
`K63.1`	Perforation of intestine (nontraumatic)	Perforation may require emergent laparoscopic repair or resection.
`K59.3`	Impaction of intestine	Severe impaction causing obstruction can lead to operative intervention.
`K50.919`	Crohn disease, unspecified, without complications	Crohn disease can cause strictures or fistulae requiring surgical resection or bypass.
`K57.30`	Diverticulitis of small intestine with perforation	Complicated small bowel diverticulitis may require laparoscopic resection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44204`	Laparoscopy, surgical; enterolysis, single or multiple	Used when isolated adhesiolysis is performed laparoscopically without bowel resection; may be reported instead of `44238` when applicable.
`44205`	Laparoscopy, surgical; lysis of adhesions (salvage of small bowel obstruction)	Employed for laparoscopic lysis of small bowel adhesions causing obstruction; select the most specific code available.
`44120`	Enterectomy, resection of small intestine with anastomosis	Open small bowel resection and anastomosis; may be used if conversion to open resection is required.
`44210`	Laparoscopy, surgical; small intestine, enterotomy, for diagnostic or therapeutic procedures	Used for laparoscopic enterotomy for repair or other therapeutic maneuvers; may be adjunctive to `44238`.
`49900`	Unlisted procedure, abdomen, peritoneum and omentum	Used when no specific abdominal procedure code exists; reserved for nonstandard procedures not described elsewhere.