1 MEDICAID CODING GUIDELINE COLONOSCOPY CPT CODES : 44388 COLONOSCOPY through stoma: diagnostic, with or without collection of specimen(s) by brushing or washing 44389 with biopsy, single or multiple 44390 with removal of foreign body 44391 with control of bleeding, any method 44392 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery 44394 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45355 COLONOSCOPY , rigid or flexible, transabdominal via colotomy, single or multiple 45378 COLONOSCOPY , flexible, proximal to splenic flexure.
2 Diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression 45379 with removal of foreign body 45380 with biopsy, single or multiple 45382 with control of bleeding, any method 45383 with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique 45384 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery 45385 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique COVERED DIAGNOSIS: Amebiasis, unspecified Colitis due to E.
3 Coli Colitis due to campylobacter Colitis pseudomembranous Infectious colitis, enteritis and gastroenteritis Colitis, enteritis, and gastroenteritis of presumed infectious origin Infectious diarrhea Diarrhea of presumed infectious origin Tuberculous peritonitis; unspecified Tuberculous peritonitis; bacteriological or histological examination not done Tuberculous peritonitis; bacteriological or histological examination unknown (at present) Tuberculous peritonitis; tubercle bacilli found (in sputum) by microscopy Tuberculous peritonitis; tubercle bacilli not found (in sputum) by microscopy, but found by bacterial culture Tuberculous peritonitis; tubercle bacilli not found by bacteriological examination, but tuberculosis confirmed by histology Tuberculous peritonitis; tubercle bacilli not found by bacteriological or histological examination but tuberculosis confirmed by other methods (inoculation of animals) Other tuberculosis if intestines, peritoneum, and mesenteric glands.
4 Unspecified bacteriological or histological examination not done bacteriological of histological examination unknown (at present) tubercle bacilli found (in sputum) by microscopy tubercle bacilli not found (in sputum) by microscopy, but found by bacterial culture tubercle bacilli not found by bacteriological exam, but tuberculosis confirmed by histology tubercle bacilli not found by bacteriological or histological exam, but tuberculosis confirmed by other methods (inoculation of animals) Malignant neoplasm of hepatic flexure Malignant neoplasm of transverse colon Malignant neoplasm of descending colon Malignant neoplasm of sigmoid colon Malignant neoplasm of cecum Malignant neoplasm of appendix Malignant neoplasm of ascending colon Malignant neoplasm of splenic flexure Malignant neoplasm of other specified sites of large intestine Malignant neoplasm of colon, unspecified Malignant neoplasm of rectosigmoid junction Malignant neoplasm of rectum Malignant neoplasm of anal canal Malignant neoplasm of anus, unspecified Malignant neoplasm of rectum, rectosigmoid junction and anus.
5 Other Malignant neoplasm of the pelvic region Secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes Secondary malignant neoplasm of large intestine and rectum Secondary malignant neoplasm of the retroperitoneum and peritoneum Secondary malignant neoplasm of liver, specified as secondary Disseminated malignant neoplasm without specification of site Benign neoplasm of colon Benign neoplasm of rectum and anal canal Carcinoma in situ of colon Carcinoma in situ of rectum and anal canal Carcinoma in situ of anal canal, anal sphincter Carcinoma in situ of anus, unspecified Neoplasm of uncertain behavior of stomach, intestines and rectum Other and unspecified neoplasm of digestive organs, , anal canal, anal sphincter, esophagus, pancreas and spleen Iron deficiency anemia secondary to blood loss (chronic)
6 Iron deficiency anemia, unspecified Anemia due to acute blood loss Acute and subacute bacterial endocarditis Hereditary hemorrhagic telangiectasia Regional enteritis of small intestine Regional enteritis of large intestine Regional enteritis of small intestine with large intestine Regional enteritis of unspecified site Ulcerative (chronic) enterocolitis Ulcerative (chronic) ileocolitis Ulcerative (chronic) proctitis Ulcerative (chronic) proctosigmoiditis Pseudopolyposis of colon Left-sided ulcerative (chronic) colitis Universal ulcerative (chronic) colitis Other ulcerative colitis Ulcerative colitis, unspecified Acute vascular insufficiency of intestine Chronic vascular insufficiency of intestine Unspecified vascular insufficiency of intestine Gastroenteritis and colitis due to radiation Toxic gastroenteritis and colitis Other and unspecified non-infectious gastroenteritis and colitis Intussusception Paralytic ileus Volvulus Intestinal or peritoneal adhesions with obstruction Other.
7 Mural thickening causing intestinal obstruction Unspecified intestinal obstruction Diverticulosis of colon (without mention of hemorrhage) Diverticulitis of colon (without mention of hemorrhage) Diverticulosis of colon with hemorrhage Diverticulitis of colon with hemorrhage Other post-operative functional disorders Functional diarrhea Megacolon, other than Hirschsprung s Neurogenic bowel Other functional disorder of the intestine, atony of colon Anal and rectal polyp Hemorrhage of rectum and anus Ulcer of anus and rectum Fistula of intestine, excluding rectum and anus Ulceration of intestine Perforation of intestine Angiodysplasia of intestine (without mention of hemorrhage)
8 Angiodysplasia of intestine with hemorrhage Other specified disorder if intestine, enteroptois, granuloma Blood in stool Hemorrhage of gastrointestinal tract, unspecified Acanthosis nigricans, acquired Other hamartoses, not elsewhere classified Diarrhea Other symptoms involving digestive system change in bowel habits, tenesmus (rectal) Nonspecific abnormal findings in stool contents Nonspecific abnormal findings on radiological and other exam; gastrointestinal tract 936 Foreign body in intestine and colon Personal history of malignant neoplasm, gastrointestinal tract, unspecified large intestine rectum, rectosigmoid junction and anus liver Personal history of unspecified digestive disease Personal history of colonic polyps MC part B news, 149,156,165,175,177 Revised: SP 2/08/02