Summary & Overview
CPT 44626: Colorectal Anastomosis After Enterostomy Takedown
CPT code 44626 represents the surgical reversal of a previously created enterostomy with construction of a colorectal anastomosis to restore intestinal continuity. This operative procedure is clinically significant because it reverses diversion created for disease, trauma, or healing, and it affects resource use, length of stay, and postoperative care pathways nationwide. The code is relevant to surgeons, hospital billing compliance teams, and payers overseeing coverage for restorative colorectal surgery.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an explanation of the clinical context for use of the code, typical sites of service, and the procedural intent. The publication provides benchmarks and coding guidance around service classification, common modifiers in use, expected claims settings, and payer considerations where available. It also outlines relevant clinical implications for patient recovery and postoperative management tied to this restorative colorectal surgery. Data not available in the input where specific payer policies, ICD-10 pairings, or associated taxonomies would normally be listed.
Billing Code Overview
CPT code 44626 describes the surgical procedure in which a previously created enterostomy is taken down and a colorectal anastomosis is created, restoring intestinal continuity so the patient can pass stool through the normal route. The procedure reverses a prior ostomy and reconnects the colon to the rectum.
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Service type: Surgical procedure — colorectal anastomosis after enterostomy takedown
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Typical site of service: Inpatient hospital operating room or surgical suite; may also be performed in an ambulatory surgical center depending on patient status and institutional policies
Clinical & Coding Specifications
Clinical Context
A typical patient for 44626 is a 58-year-old adult who previously underwent a temporary diverting colostomy for complicated diverticulitis with peritonitis. After recovery and confirmation of healed distal bowel by contrast enema and colonoscopy, the surgeon schedules takedown of the enterostomy and creation of a colorectal anastomosis to restore intestinal continuity. The preoperative workflow includes preoperative evaluation, informed consent discussing risks (anastomotic leak, infection, bleeding), bowel preparation as indicated, perioperative antibiotics, and anesthesia evaluation. Intraoperatively the patient is positioned supine, the ostomy site is mobilized, adhesions are lysed as needed, the distal bowel segment is evaluated, and a colorectal anastomosis is fashioned (stapled or hand-sewn). Postoperatively the patient is monitored for return of bowel function, signs of leak or infection, and is advanced diet per recovery; discharge planning includes wound care and follow-up with the colorectal surgeon.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier required / default | Use when no specific modifier applies to the service |
51 |