CPT® Code 44145

The CPT® Code 44145 refers to a partial colectomy procedure that includes a coloproctostomy, specifically involving a low pelvic anastomosis. This surgical intervention is performed to remove a diseased segment of the colon while preserving the rectum. The procedure begins with a midline incision in the abdomen, allowing the surgeon to inspect the abdominal cavity thoroughly. The superior rectal vessels are identified and carefully dissected from the sacral promontory, followed by ligation and division to ensure proper blood supply management during the surgery. The rectum is then mobilized, which involves detaching it from surrounding tissues to facilitate access to the colon. The segment of the colon that is affected by disease is also mobilized to prepare for resection. Once the diseased segment is identified, the colon is clamped above and below the planned transection sites to prevent blood loss and contamination. The surgeon transects the colon, removing the diseased portion, and subsequently sutures the remaining distal and proximal segments together in a process known as anastomosis. This procedure is specifically coded as 44145 when it is performed without creating a colostomy. In contrast, if a colostomy is necessary, the procedure would be coded as 44146. The detailed steps of the procedure ensure that the patient can maintain bowel continuity while addressing the underlying condition effectively.