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The CPT® Code 44370 refers to a specific medical procedure known as small intestinal endoscopy, specifically an enteroscopy that extends beyond the second portion of the duodenum, excluding the ileum. This procedure involves the use of a flexible fiberoptic endoscope, which is a specialized instrument designed for visual examination of the small intestine. The duodenum, which is the first section of the small intestine, is anatomically divided into four distinct portions: the duodenal bulb or cap, the descending portion, the transverse portion, and the ascending portion. During the procedure, the patient is typically administered a local anesthetic spray to numb the throat and mouth, facilitating the insertion of the endoscope. A hollow mouthpiece is utilized to keep the mouth open, allowing for easier passage of the endoscope as the patient swallows it. Once the endoscope is successfully navigated beyond the cricopharyngeal region, it is carefully guided into the duodenum under direct visualization. The physician inspects the mucosal surfaces of the small intestine, extending the examination to areas beyond the second portion of the duodenum, which may include the jejunum, but intentionally excludes the ileum. Any abnormalities observed during this inspection are meticulously documented. If a stenosis, or narrowing, is identified, the area may be predilated to facilitate the placement of a stent. The physician assesses the position and length of the stenosis to select an appropriately sized stent, which is then introduced through the endoscope. The stent is positioned within the narrowed segment of the small intestine and deployed, or expanded, to alleviate the obstruction. Additionally, separate radiographs may be obtained to evaluate the stent's expansion and confirm its proper positioning within the gastrointestinal tract.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 44370 is indicated for various conditions affecting the small intestine, particularly when there is a need to address stenosis or narrowing beyond the second portion of the duodenum. The following are specific indications for performing this procedure:
The procedure for CPT® Code 44370 involves several critical steps to ensure effective examination and treatment of the small intestine. The following outlines the procedural steps:
After the completion of the procedure, the patient may require monitoring for any immediate complications or adverse effects related to the endoscopy and stent placement. Post-procedure care typically includes observation for signs of bleeding, infection, or perforation. Patients may also be advised on dietary modifications and follow-up appointments to assess the effectiveness of the stent and monitor for any recurrence of symptoms. It is essential for healthcare providers to provide clear instructions regarding any restrictions or necessary follow-up imaging to ensure optimal recovery and management of the patient's condition.
| Short Descr | SMALL BOWEL ENDOSCOPY/STENT | Medium Descr | ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT | Long Descr | Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation) | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 44360 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 96 - Other OR lower GI therapeutic procedures |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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