2025 CPT code 44366
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopic Small Intestine Procedures Surgical Procedures on the Digestive System Feed
Small intestinal endoscopy beyond the second part of the duodenum, not including the ileum, with bleeding control.
Modifiers may be applicable based on specific circumstances.For example, modifier 51 might be used for multiple procedures, and modifiers indicating the use of anesthesia or sedation might also be necessary. Consult the most recent CPT guidelines for the applicable modifier rules and restrictions.
Medical necessity for code 44366 is established when a patient presents with symptoms indicating gastrointestinal bleeding and imaging studies or other diagnostic procedures point towards a source within the specified region of the small bowel. The procedure is medically necessary to diagnose and control acute bleeding, thereby preventing complications like anemia, hypovolemic shock, or the need for more invasive surgical intervention.
The physician is responsible for the entire procedure, including patient preparation, anesthesia administration (if applicable), endoscopic insertion and manipulation, visualization of the small intestine, identifying the bleeding source, and implementing the chosen bleeding control technique. Post-procedure monitoring and patient discharge instructions are also the physician's responsibility.
- Surgical Procedures on the Digestive System
- Surgical Procedures on the Digestive System > Surgical Procedures on the Intestines (Except Rectum) > Endoscopic Small Intestine Procedures
In simple words: The doctor uses a long, thin, flexible tube with a camera (endoscope) to examine the small intestine.If bleeding is found, they stop it using methods like injections, heat, laser, or special tools. The procedure goes beyond the beginning of the small intestine but does not reach the end.
This CPT code encompasses small intestinal endoscopy (enteroscopy) extending beyond the duodenum's second portion but excluding the ileum.The procedure involves controlling bleeding using various methods such as injection, bipolar or unipolar cautery, laser, heater probe, stapler, or plasma coagulator. The scope's insertion is typically oral, but an abdominal incision might be used to facilitate the procedure.Imaging is achieved through a camera on the endoscope transmitting images to a monitor, allowing visualization of the intestinal lining for assessment and identification of bleeding sources.
Example 1: A patient presents with unexplained gastrointestinal bleeding.Enteroscopy is performed, revealing a bleeding ulcer in the jejunum. The physician employs bipolar cautery to control the hemorrhage.Code 44366 is reported., During a routine small bowel endoscopy, a small angiodysplasia is found to be actively bleeding in the jejunum. The physician uses injection therapy to stop the bleeding.Code 44366 is reported., A patient experiences persistent lower GI bleeding. Enteroscopy is performed, identifying a bleeding polyp.The physician uses a snare to remove the polyp and further applies argon plasma coagulation to control remaining bleeding. Code 44366 is reported.
Detailed documentation is crucial and must include the type of enteroscopy performed (antegrade), the extent of the examination (beyond the duodenum's second portion, not including the ileum), location(s) of bleeding, methods used for bleeding control (specific technique, e.g., injection of epinephrine, bipolar cautery), and any biopsies or other procedures performed during the session. Preoperative and postoperative diagnoses, patient vital signs, and the anesthesiologist's report (if applicable) should also be documented.
** Accurate coding relies on detailed documentation of the procedure, including the location and nature of the bleeding, the methods used for control, and the extent of the small bowel examination.Always consult the most recent CPT coding manuals and payer-specific guidelines to ensure accurate billing and reimbursement.
- Revenue Code: P8I (ENDOSCOPY - OTHER)
- RVU: Consult the Medicare Physician Fee Schedule (MPFS) for the most up-to-date RVU and reimbursement information.Reimbursement varies based on location and other factors.
- Global Days: The global surgical period for this procedure is not explicitly defined in the provided information.Refer to payer-specific guidelines for details.
- Payment Status: Active
- Modifier TC rule: The application of a Technical Component (TC) modifier to code 44366 depends on the specific circumstances of the procedure and payer requirements. Refer to your local Medicare Administrative Contractor (MAC) and payer-specific guidelines for TC modifier rules.
- Fee Schedule: Fee schedules vary considerably by payer, location, and year.Historical fee schedule data can be accessed through various commercial medical billing databases.The information provided here is insufficient to produce a detailed historical fee schedule.
- Specialties:Gastroenterology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)