Colon and rectal surgical procedures are commonly performed by colorectal surgeons, general surgeons, surgical oncologists, and other surgical subspecialists. Complicated operations are often performed simultaneously with other specialty surgeons as part of a multidisciplinary effort. The rules and regulations surrounding proper coding can be complicated and unclear, particularly if the operations are complex or involve multiple surgeons. Many surgeons do not undergo formal training in coding; rather, they learn “on the job” from colleagues or mentors, which can influence the quality of their coding. Additionally, proper documentation is a prerequisite to proper coding and consequently reimbursement, particularly when it comes to the use of modifiers and code edits. What constitutes “adequate” documentation from a coding perspective is not always clear. This paper aims to review CPT codes, code modifiers and guidelines to facilitate accurate coding for complex open abdominal colorectal procedures based on the Current Procedural Terminology (CPT) and National Correct Coding Initiative (NCCI) manuals.