A patient has a colostomy and a physician performs a colonoscopy to the cecum through the colostomy, which is reported with 44388 (REVISED IN 2015), Colonoscopy through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure). The scope is withdrawn and inserted into the rectum up 30 cm to review the Hartmann pouch. Is it appropriate to report CPT code 44388 and 45330 , Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure), or is it only appropriate to report CPT code 44388 ? ...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This premium coding article explains a CPT-focused scenario involving endoscopic evaluation through a colostomy and an additional examination of the rectal pouch. It is aimed at coders and billing staff who need to understand how the procedures are represented in the CPT system, how sedation is treated at a high level, and why payer-specific reporting rules may affect final claims submission. The article also notes the possible relevance of common multiple-procedure and distinct-service modifiers in this context.

Why This Topic Matters

Endoscopic procedures in patients with ostomies can involve more than one reportable service, and coding decisions may be affected by the anatomy examined and the payer’s claim-editing rules. Understanding the article helps reduce coding uncertainty and supports more consistent claim reporting.

Codes Discussed

• CPT: 44388
• CPT: 45330

Modifiers Discussed

• CPT: 51
• CPT: 59

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