CPT® Code 44021

An enterotomy is a surgical procedure that involves making an incision in the small intestine, specifically in a segment other than the duodenum. This procedure is typically performed for various reasons, including exploration of the intestinal lumen, obtaining tissue biopsies, or removing foreign bodies. During the operation, the surgeon makes an incision in the abdominal wall to access the small intestine. The targeted segment of the intestine is then carefully extracted from the abdominal cavity and placed on the operating table for further examination. To facilitate the procedure, pressure is applied to the intestinal segment to express its contents, allowing for a clearer view of the internal structures. The intestine is clamped both distal and proximal to the site of the incision to prevent the contents from spilling into the abdominal cavity. Once the segment is secured, an incision is made in the intestinal wall, and the internal lumen is explored. This exploration may involve taking tissue samples for pathological analysis or removing any foreign objects that may be obstructing the intestine. After the necessary interventions are completed, the intestinal incision is meticulously closed, and the clamps are removed. The segment is then returned to the abdominal cavity, and the abdominal incision is closed. In the context of CPT® Code 44021, the enterotomy is specifically performed for decompression purposes. This involves isolating the segment of bowel to be incised, placing a purse-string suture around it, and making a small nick incision through the intestinal wall. A trocar and cannula connected to suction tubing are then inserted through this incision, allowing the surgeon to decompress the distended loops of intestine effectively. After the decompression is completed, the suction tubing is withdrawn, and the purse-string suture is tied around the incision, with an additional purse-string suture placed around the wound to ensure proper closure.