Summary & Overview
CPT 44346: Colostomy (Stoma) Revision Surgery
CPT code 44346 denotes surgical revision of an existing colostomy, including release of the intestinal segment from the stoma, repair of entrapped bowel or hernia, removal of peristomal scar tissue, and recreation of the stoma at a new abdominal wall site. Nationally, this code captures a focused set of reconstructive procedures important for postoperative management of colostomy complications and for patients with parastomal hernias or stenosis. Payers use this code to classify surgical quality, utilization, and reimbursement for stoma-related reconstructive care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers how these payers typically handle surgical stoma revision claims, common billing considerations, and where CPT code 44346 fits within procedural groupings used for authorization and payment.
Readers will learn the clinical context of the procedure, typical sites of service, and how CPT code 44346 is applied in billing workflows. The publication also summarizes benchmark metrics, common coding and billing issues, and recent policy updates affecting surgical revision of colostomies. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 44346 describes surgical revision of a previously constructed colostomy. The procedure involves releasing the intestinal segment from its stoma, returning entrapped bowel of a hernia to its proper place, excising scar tissue around the stoma, and reattaching the stoma at a new site in the abdominal wall.
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Service type: Surgical stoma revision/colostomy revision
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Typical site of service: Inpatient or outpatient operating room in a hospital or surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a previously formed colostomy who presents with stoma-related complications such as chronic peristomal scarring, recurrent parastomal hernia with entrapped bowel, or stoma retraction and ischemia. The patient may report pain, bowel obstruction symptoms, leakage around the appliance, or difficulty maintaining a seal. Preoperative evaluation includes history and physical, imaging (abdominal CT or contrast studies) to assess for hernia or bowel compromise, optimization of comorbidities (eg, diabetes, anticoagulation), and informed consent explaining stoma revision with relocation. In the operating room under general anesthesia, the surgeon dissects the existing stoma, frees the intestinal segment, reduces any herniated or entrapped bowel, excises scar tissue and nonviable skin, and matures the stoma at a new abdominal site with appropriate fascial repair. Typical postoperative workflow includes monitoring for bowel perfusion, pain control, early ambulation, stoma care teaching with Wound, Ostomy and Continence (WOC) nurse, and follow-up for wound and hernia repair status. Typical site of service is an inpatient or outpatient hospital surgical suite or ambulatory surgery center depending on patient acuity and comorbidities. Service type: surgical procedure (stoma revision/relocation).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Primary procedure | Use when this 44346 is the primary service of the encounter. |