CPT® Code 44604

Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy

Suture repair of the large intestine, known as colorrhaphy, is a surgical procedure aimed at addressing various conditions that result in perforations of the large intestine. This procedure is specifically indicated for cases involving perforated ulcers, diverticula, wounds, injuries, or ruptures, which can lead to serious complications if not treated promptly. During the operation, a surgical incision is made in the abdomen to access the affected segment of the large intestine. The surgeon carefully removes the segment that requires repair and places it on the operating table for further manipulation. The contents of the intestine are expressed to ensure a clear working area. To manage the perforation, the intestine is clamped above and below the site of injury, allowing for controlled repair. Any bleeding that may occur is addressed through the suture ligation of the involved blood vessels. The repair itself involves suturing the mucous membranes of the intestine, followed by the serous coat and the muscular wall, ensuring a secure closure. After the repair is completed, the abdominal cavity is thoroughly cleansed using gauze and irrigation fluid as necessary to minimize the risk of infection. Depending on the clinical situation, drains may be placed to facilitate fluid management, and the abdominal incision is subsequently closed. It is important to report CPT® Code 44604 for this suture repair procedure when it is performed without the creation of a colostomy. In contrast, if a colostomy is also performed, CPT® Code 44605 should be reported, which involves additional steps for creating a stoma from the colon.