Summary & Overview
CPT 44602: Small Intestine Repair with Peritoneal Irrigation
CPT code 44602 represents operative repair of a small intestinal tear or perforation with suture closure and abdominal irrigation. This procedure is clinically important because it addresses potential contamination of the peritoneal cavity with enteric contents, a key driver of morbidity and resource use in acute care surgery. Nationally, management of small bowel perforations impacts emergency surgical volume, inpatient lengths of stay, and sepsis prevention efforts.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical sites of service, and the service type. The publication summarizes typical billing considerations and common modifiers used with this procedure (where provided), and outlines expected clinical context and utilization implications for acute care settings. Benchmarks, payer coverage notes, and policy updates are addressed to help coding and revenue teams align documentation and claim submission practices with payer expectations. The summary also contextualizes the code within surgical service lines and emergency operative care to support operational planning and coding accuracy.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and payer-specific reimbursement rates.
Billing Code Overview
CPT code 44602 describes a surgical repair of a tear or hole in the wall of the small intestine with sutures, combined with irrigation of the abdominal cavity using an antibiotic solution or normal saline. The procedure is performed to prevent contamination of the peritoneal cavity with intestinal contents and to reduce the risk of intra-abdominal infection.
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Service type: Surgical repair of small intestinal perforation (open or exploratory surgical approach with primary repair and peritoneal irrigation)
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Typical site of service: Hospital operating room, often performed as an emergency or urgent intra-abdominal procedure with post-operative inpatient care as indicated
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to the emergency department with acute abdominal pain, fever, and signs of peritonitis after a suspected penetrating abdominal injury. Imaging and clinical exam suggest a full-thickness small bowel perforation with localized contamination. The patient is taken to the operating room for an urgent exploratory laparotomy. The surgeon identifies a 2-cm tear in the jejunum, performs primary suture repair of the enterotomy, and performs abdominal lavage with antibiotic solution to reduce contamination. Standard perioperative care includes general anesthesia, intravenous antibiotics, intraoperative fluid management, and postoperative monitoring in the surgical ward or intensive care unit depending on stability. The procedure is documented as repair of small intestine tear with irrigation of the peritoneal cavity to prevent intra-abdominal infection and continued postoperative antibiotics and wound surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds typical for 44602 due to extensive contamination, dense adhesions, or multiple repairs. |
23 |