Medical Billing · Nationwide
Pediatric Hirschsprung Disease & Transanal Endorectal Pull-Through (TERPT / Soave / Duhamel) Medical Billing Services
Surgical management of congenital aganglionic megacolon: primary transanal endorectal pull-through (TERPT), laparoscopic-assisted Soave/Duhamel pull-through, multi-level seromuscular mapping biopsies (+44150/+45110/88305), colonic leveling, and staged diversion reversal.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to pediatric general surgeons, pediatric colorectal centers, neonatal surgeons, and specialized pediatric gastroenterology institutes across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical pediatric hirschsprung disease & transanal endorectal pull-through (terpt / soave / duhamel) CPT range we work: 44145, 44146, 44147, 44150, 44151, 45110, 45112, 45120, 49320, 88305.
Why pediatric hirschsprung disease & transanal endorectal pull-through (terpt / soave / duhamel) billing leaks revenue
Diagnostic leveling biopsy bundling: Payers bundling multiple intraoperative frozen section seromuscular leveling biopsies into primary proctectomy
Laparoscopic assistance unbundling denials: Disallowance of diagnostic/interventional laparoscopy (49320) during transanal endorectal mobilization
Staged diversion reversal global period clawbacks: Denials of subsequent pull-through following neonatal leveling colostomy absent Modifier -58
Pelvic muscular cuff dissection downcoding: Rejection of complex dissection modifiers on muscular sleeve cuff creation in ultra-low rectal aganglionosis
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
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Pediatric Hirschsprung Disease & Transanal Endorectal Pull-Through (TERPT / Soave / Duhamel) billing FAQ
How is a transanal endorectal pull-through (TERPT / Soave) coded in pediatric patients?
Transanal endorectal pull-through for Hirschsprung disease is commonly reported with CPT 45120 (proctectomy, complete (for congenital conditions, eg, Hirschsprung disease or meconium ileus); combined abdominal and perineal approach) or CPT 45112 (proctectomy, combined abdominoperineal, pull-through procedure; eg, colo-anal-anastomosis) or CPT 44145/44146 depending on the exact approach. When diagnostic laparoscopy is utilized to mobilize the splenic flexure or take leveling biopsies, CPT 49320 or 44204 is reported with appropriate unbundling documentation.
Can intraoperative leveling biopsies be separately billed during Hirschsprung surgery?
Multiple leveling seromuscular full-thickness biopsies performed to establish normal ganglion cell presence at the proximal resection margin are separately billable with Modifier -59 or -XU when taken at distinctly documented colonic locations prior to selecting the transection site.