Summary & Overview
CPT 44314: Ileostomy (Stoma) Revision
CPT code 44314 designates surgical revision of an ileal stoma, involving release of the ileal intestinal segment, removal of peristomal scar tissue, and recreation of the stoma at a new abdominal site. This procedure is clinically important for patients with stoma complications such as retraction, stenosis, or recurrent irritation, and has implications for postoperative care, surgical planning, and facility utilization. Nationally, accurate coding for stoma revision affects procedure-level reporting, quality measurement, and appropriate facility and professional billing.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how payers typically handle coverage for stoma revision based on clinical indications and site-of-service considerations.
Readers will find a concise clinical context for the procedure, expected sites of service (operative suite, inpatient or ambulatory surgical center), and a discussion of common billing considerations. The report also summarizes typical modifiers used with this CPT code, common documentation elements that support medical necessity, and how this code relates to broader surgical and postoperative care workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 44314 describes a surgical procedure to revise an existing ileostomy. The provider releases the ileal intestinal segment from its current stoma, excises surrounding scar tissue, and recreates the stoma at a new site on the abdominal wall.
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Service type: Stoma revision surgery (surgical, operative)
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Typical site of service: Operative suite or hospital inpatient/ambulatory surgical center depending on clinical need and patient status
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a previously created ileostomy who presents with stoma-related complications such as retraction, peristomal scarring, chronic irritation, or stenosis that prevent a functional pouching system or cause recurrent skin breakdown and infection. The patient often has a history of inflammatory bowel disease, prior abdominal surgery, or oncologic resection requiring an ileal conduit or diversion. Preoperative workup includes physical stoma assessment, stoma site marking, nutritional and wound-healing optimization, and anesthesia evaluation. In the operating room under general anesthesia, the surgeon releases the ileal intestinal segment from the existing stoma, excises peristomal scar tissue and adhesions, mobilizes the ileal segment to ensure adequate blood supply and length, and recreates the stoma at a new abdominal site with mucocutaneous fixation. Postoperative care focuses on stoma function assessment, wound care, pain control, and ostomy nurse education for appliance fitting. Typical recovery includes short hospital admission for monitoring for ischemia, infection, or bowel obstruction and outpatient ostomy follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work substantially exceeds typical; document reasons such as extensive adhesiolysis or complex scar excision. |