Add 44705 to Your Coding Arsenal
"We had previously covered that in 2013 we will see an end to your reporting fecal bacteriotherapy with an unlisted code." You can now update your list of codes with a code for reporting fecal bacteriotherapy, also known as a fecal intestinal transplant (FIT), when your gastroenterologist performs it. So, if your gastroenterologist performs a stool transplant, you will report part of this service with 44705 (Preparation of fecal microbiota for instillation, including assessment of donor specimen).
In addition to the preparation of the donor specimen (reported using 44705), you will have to use the appropriate code for the instillation of the specimen in the gut. Depending on choice, your gastroenterologist might perform a colonoscopy, EGD, rectal enema or a nasogastric tube to instill the specimen. For example, if your gastroenterologist uses an EGD to instill the specimen, you should report 43235 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) along with 44705 for the preparation of the specimen.
Example: Your gastroenterologist decides to perform stool transplant on a patient suffering from C. difficile infection not responding to antibiotic treatment and other forms of treatment. He decides to use a sample from the patient's spouse for the transplant. He orders a thorough assessment of the stool sample to check for communicable diseases and other parasitic infections. He then prepares a sample for instilling in the patient's gut.
Your gastroenterologist then performs a colonoscopy to instill the stool sample. You will report the services using 44705 for the preparation and assessment of the stool sample and 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]) for the colonoscopy he performed to place the stool sample in the patient's gut.