Summary & Overview
CPT 44345: Colostomy (stoma) relocation and revision
CPT code 44345 represents surgical revision of a colostomy with release of the colon segment from its stoma, removal of peristomal scar tissue, and reattachment of the stoma at a new abdominal site. This procedure is clinically important for managing stoma complications such as stenosis, retraction, or persistent peristomal irritation, and it has implications for surgical resource utilization and postoperative care nationwide.
Key payers typically covering this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing profile of the code, including typical sites of service, common payer coverage patterns, and where to find related billing considerations. The publication also summarizes benchmark-oriented topics such as relative utilization and common modifier usage patterns when available.
This overview is intended to help clinical administrators, coding specialists, and policy analysts understand the clinical scope of 44345, how it is positioned within surgical service lines, and which payers are commonly involved in coverage. Data not available in the input is noted where applicable, and the content is presented for a national audience without state-specific policy detail.
Billing Code Overview
CPT code 44345 describes a surgical procedure to relocate an existing colostomy. The provider frees the colon segment from its stoma, excises scar tissue surrounding the stoma site, and reestablishes the stoma at a new location on the abdominal wall.
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Service type: Ostomy revision / stoma relocation surgical procedure
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old person with a mature colostomy that has symptomatic peristomal scarring, stenosis, or recurrent parastomal skin breakdown causing poor appliance fit and chronic leakage. The patient presents to a colorectal surgeon in the outpatient preoperative clinic with complaints of frequent skin irritation, difficulty maintaining an ostomy appliance seal, and localized pain around the stoma. Conservative measures (ostomy nurse refitting, topical therapy, and local steroid or steroid-sparing treatments) have failed. Preoperative evaluation includes stoma and abdominal wall assessment, nutritional and wound-healing risk optimization, and review of prior operative reports and imaging to confirm bowel viability and identify adhesions.
On the day of service the procedure is performed in an ambulatory surgery center or hospital operating room under general anesthesia. The surgeon mobilizes the bowel from the existing stoma site, excises fibrotic peristomal scar tissue, repositions and matures the stoma at a new abdominal site, and secures the bowel to the fascia with appropriate technique. Intraoperative steps commonly include adhesiolysis, hemostasis, irrigation, and layered closure of the old defect. Postoperative care involves stoma assessment, pain control, monitoring for bleeding or bowel compromise, and ostomy nurse education prior to discharge. Typical follow-up occurs within 1–2 weeks for wound and stoma review.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—standard reporting |