Colorectal Surgery & Pelvic Exenteration Scrubber
Colorectal oncology cases face aggressive payer auditing: clearinghouses bundle protective diverting loop ileostomies (44320) into low anterior resections (45119), downcode colonic J-pouch reservoirs to simple colectomy (44145), and reject co-surgeon Modifier -62 claims during multivisceral pelvic exenteration (45126). Audit your operative dictation for bulletproof compliance.
Colorectal Surgery & Pelvic Exenteration Scrubber
Model total mesorectal excision (TME), multivisceral pelvic exenterations, colonic J-pouch reservoirs, and protective diverting loop ileostomies. Enforces Modifier -62 co-surgeon validation, protects against partial colectomy downcoding, and eliminates fatal NCCI stoma unbundling denials.
Operative note substantiates CPT 45119. Colonic pouch creation is fully reimbursable over simple LAR.
Medical necessity verified: Prior radiation (Yes) and ultra-low anastomotic height justify non-integral diversion through separate counter-incision.
| Code | Mod | wRVU | Fee | Status |
|---|---|---|---|---|
| 45119 Proctectomy with colonic J-pouch reservoir & coloanal anastomosis | None | 54.8 | $3920.00 | clean |
| 44320 Creation of protective loop ileostomy | XE | 24.2 | $1740.00 | clean |
| 52005-50 Bilateral ureteral stent placement performed by attending Urologist | Billed on Urologist NPI | 6.8 | $480.00 | clean |
| 0596T Temporary Cat III: Noncontact near-infrared fluorescence imaging of vascular perfusion | None | 4.2 | $320.00 | clean |
ISA*00* *00* *ZZ*AETHERA_RCM *ZZ*PAYER_CLEARING *260905*1400*^*00501*000000101*0*P*:~ GS*HC*AETHERA_RCM*PAYER_CLEARING*20260905*1400*101*X*005010X222A1~ ST*837*0001*005010X222A1~ BHT*0019*00*COLORECTAL_EXENT*20260905*1400*CH~ NM1*85*2*AETHERA COLORECTAL ONCOLOGY LLC*****XX*1992019920~ N3*100 COLONIC SURGERY WAY*SUITE 400~ N4*BALTIMORE*MD*21201~ NM1*82*1*SURGEON*COLORECTAL****XX*1447289102~ PRV*BI*PXC*208C00000X~ NM1*IL*1*DOE*PATIENT****MI*AET99821034~ CLM*COLORECTAL-2026-9912*5980.00***11:B:1*Y*A*Y*Y~ HI*ABK:C20*ABF:Z85.048*ABF:Z92.3~ SV1*HC:45119*3920.00*UN*1***1:2~DTP*472*D8*20260905~ SV1*HC:44320:XE*1740.00*UN*1***1:2~DTP*472*D8*20260905~ SV1*HC:52005-50:BilledonUrologistNPI*480.00*UN*1***1:2~DTP*472*D8*20260905~ SV1*HC:0596T*320.00*UN*1***1:2~DTP*472*D8*20260905~ SE*19*0001~ GE*1*101~ IEA*1*000000101~
Turn these Colorectal Surgery & Pelvic Oncology RCM insights into recovered cash
Tired of commercial payer clawbacks on low anterior resections, bundled loop ileostomies, or disputed pelvic exenteration co-surgery? Aethera's specialized colorectal billing team recovers 100% of earned RVUs. Let our senior AAPC-certified billing team audit 50 of your active claims or past denials — completely free, with guaranteed under-48-hour findings.
Test our scrub rules and appeal workflow on 50 real claims. Zero commitment, no credit card required.
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