CPT® Code 44346

The procedure described by CPT® Code 44346 refers to the revision of a colostomy that includes the repair of a paracolostomy hernia, which is classified as a separate procedure. A colostomy is a surgical opening created in the abdominal wall to allow for the diversion of stool from the colon into a colostomy bag. Over time, complications may arise that necessitate a revision of the colostomy. These complications can include constriction or obstruction of the stoma, prolapse of the intestine through the stoma, retraction of the intestine causing the stoma to sink below the skin level, detachment of the intestine from the skin, necrosis of the tissue, or the development of a parastomal hernia. The revision process may vary in complexity, with simpler revisions involving the release of superficial scar tissue, while more complicated revisions may require excision of necrotic bowel and reconstruction or relocation of the stoma. In the case of a paracolostomy hernia, which occurs when tissue protrudes through the abdominal wall near the stoma, the procedure involves making an incision over the hernia, reducing it, and repairing the overlying fascia either with sutures or through the use of a mesh implant. This procedure is critical for restoring the integrity of the abdominal wall and ensuring the proper function of the colostomy.