CPT® Code 44322

The CPT® Code 44322 refers to a surgical procedure involving the creation of a colostomy or skin level cecostomy, specifically when multiple biopsies are performed, often for conditions such as congenital megacolon. This procedure is classified as a separate procedure, indicating that it is distinct from other surgical interventions that may be performed concurrently. The process begins with a midline abdominal incision, allowing access to the peritoneal cavity, where the abdomen is thoroughly explored to identify any adhesions that may need to be lysed. The targeted segment of the colon or cecum is then mobilized, and a separate incision is made in the lower abdomen to prepare a stoma site, typically on the right side. The procedure involves clamping the colon or cecum above and below the planned transection site, followed by transection of the bowel. The distal segment is closed with sutures, while the proximal segment is exteriorized, everted, and sutured to the skin and subcutaneous tissue to create the stoma. The abdominal incision is subsequently closed, and a stomal appliance is applied. It is important to note that this code is specifically used when multiple biopsies of the intestinal mucosa are obtained for pathological evaluation, distinguishing it from similar procedures that do not involve biopsies.