CPT 0780T: Fecal Microbiota Transplantation via Rectal Enema

Headline: CPT code 0780T covers fecal microbiota transplantation via rectal enema, a therapeutic procedure to restore gut microbiota.

Lead: CPT code 0780T denotes a fecal microbiota transplantation (FMT) delivered by rectal enema, a clinical intervention used to repopulate healthy intestinal flora. The code standardizes reporting for a procedure that has increasing clinical relevance for certain infectious and dysbiosis-related conditions.

What it represents and national importance: This CPT code captures the endoscopic-free, enema-based route of donor stool administration. As interest in microbiome-targeted therapies grows, a discrete code for the enema route enables clearer tracking of utilization, coverage decisions, and comparative outcomes across providers and payers nationally.

Key payers covered: The analysis includes coverage and coding considerations for Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

What readers will learn: The publication provides benchmarks and clinical context for CPT code 0780T, summarizes payer coverage patterns where available, and outlines coding and billing considerations specific to the enema route of fecal microbiota transplantation. It highlights common sites of service and the procedural service type to aid administrative and clinical stakeholders in identifying where this code applies.

Data limitations: Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific policy language.

Billing Code Overview

CPT code 0780T describes a fecal microbiota transplantation (FMT) performed via rectal enema, in which a provider transplants fecal bacteria from a healthy donor into a recipient. The procedure involves preparation and delivery of donor stool material to the recipient's rectum using an enema administration technique.

Service type: Therapeutic microbiota transplantation
Typical site of service: Ambulatory procedure setting or clinic, or inpatient hospital setting when performed as a bedside procedure

Clinical Context

A typical patient is a 45–75-year-old adult with recurrent Clostridioides difficile infection (rCDI) unresponsive to standard antibiotic therapy, or a patient with other investigational indications enrolled in a clinical protocol. The clinical workflow begins with referral from the gastroenterology or infectious disease clinic. Pre-procedure steps include donor screening (medical history, infectious disease testing), informed consent, medication reconciliation (holding antibiotics per protocol), and bowel preparation as indicated. On the day of service the procedure is performed in an outpatient endoscopy or ambulatory procedure suite. The provider prepares the donor fecal material, typically processed and suspended in isotonic solution, and administers the preparation via rectal enema to the recipient. The patient is monitored for immediate adverse events for a short post-procedure observation period and receives discharge instructions including signs of infection or adverse reaction and follow-up appointments. Documentation includes donor screening records, recipient consent, lot/identifier for the transplant material, procedural note describing enema administration, and post-procedure monitoring and instructions.

Coding Specifications

Modifier	Description	When to Use
`23`	Unusual Anesthesia	Use if general anesthesia is unexpectedly required for the enema procedure when anesthesia is not normally required.

Taxonomy Code	Specialty	Notes
207RC0000X	Colon and Rectal Surgery	Surgeons who may perform or oversee the procedure in complex anatomic or surgical patients.
207H00000X	Gastroenterology	Gastroenterologists commonly perform or supervise fecal microbiota transplantation via rectal enema.
208000000X	Family Medicine	Family physicians may coordinate or perform in outpatient settings where allowed by protocol.
207K00000X	Infectious Disease	Infectious disease specialists often manage indications, donor screening, and follow-up for rCDI cases.
363L00000X	Clinical Laboratory	Laboratory providers responsible for donor testing and stool processing; included when billing laboratory services adjunctive to the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`A04.71`	Enterotoxigenic Escherichia coli infection, recurrent	Included as an example of infectious colitis that may prompt consideration of microbiota-based therapies in investigational settings.
`A04.72`	Enterotoxigenic Escherichia coli infection, persistent	Represents persistent enteric infection where microbiome restoration may be considered in research contexts.
`A04.7`	Enterocolitis due to other specified organisms	Covers other infectious enterocolitides that may be evaluated in relation to microbiome-based interventions.
`A04.71`	Recurrent C. difficile infection (representative code for rCDI management)	Recurrent C. difficile is the primary standard indication for fecal microbiota transplantation via rectal enema; the procedure aims to restore healthy gut flora and resolve recurrent infection.
`K52.9`	Noninfective gastroenteritis and colitis, unspecified	Used when specific infectious etiology is not documented but symptoms suggest colitis that may lead to consideration of fecal transplant in investigational scenarios.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`45378`	Diagnostic colonoscopy, flexible; with biopsy, single or multiple	May be performed prior to fecal transplant to evaluate colonic pathology or obtain biopsies when clinically indicated.
`45380`	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Performed if therapeutic polypectomy is required during the same encounter; modifier `51` may apply when billed with the enema procedure.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	May be used for administration of adjunctive medications (e.g., antiemetics) in the peri-procedural period.
`99499`	Unlisted evaluation and management service	May be used for non-standard pre-procedure counseling or coordination not represented by other E/M codes when billed separately, subject to payer rules.
`87491`	Infectious agent antigen detection by immunoassay with direct optical observation; Clostridium difficile toxin A and B	Represents laboratory testing relevant to diagnosis or follow-up testing for C. difficile prior to or after transplant (laboratory codes billed by lab providers).

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Summary & Overview