Summary & Overview
CPT 44360: Diagnostic Upper Small Bowel Endoscopy with Brushing
CPT code 44360 denotes diagnostic upper small bowel endoscopy performed through the mouth to evaluate the duodenum and jejunum, with brushing or washing to collect cells for laboratory analysis. This procedure is used to investigate causes of gastrointestinal symptoms such as bleeding and diarrhea when visualization and cytologic sampling of the proximal small intestine are required. Nationally, the code is relevant for gastroenterology service lines, hospital outpatient workflow, and endoscopy centers that manage diagnostic workups for small-bowel pathology.
Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and common billing considerations tied to the code’s diagnostic intent. The publication summarizes benchmark payment themes and payer coverage patterns, outlines documentation elements that support medical necessity, and identifies coding relationships clinicians and billing staff should be aware of.
This summary provides a national overview for administrators, coding professionals, and clinicians seeking clarity on the clinical use and billing context of CPT code 44360. Data not available in the input for specific payer rates, associated taxonomies, and ICD-10 mappings.
Billing Code Overview
CPT code 44360 describes an endoscopic examination of the proximal small intestine performed via the mouth. The procedure visualizes the first and second portions of the duodenum and extends into the jejunum, excluding the ileum. The clinician inspects the mucosa for abnormalities such as sources of gastrointestinal bleeding or causes of diarrhea and collects cellular material by brushing or washing suspicious areas for laboratory analysis.
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Service type: Diagnostic endoscopy of the proximal small intestine with brushing/washing for cytology
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or endoscopy suite in a clinic setting
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents to the gastroenterology clinic with several weeks of melena, intermittent epigastric pain, and unintentional weight loss. Noninvasive testing (fecal occult blood testing and laboratory studies) suggests ongoing upper gastrointestinal blood loss. The gastroenterologist schedules an upper endoscopy with evaluation of the proximal small intestine to identify a bleeding source or mucosal abnormality. During an upper endoscopic procedure performed in an outpatient endoscopy suite, the provider advances a standard upper endoscope through the esophagus and stomach into the duodenum, inspects the first and second portions of the duodenum, and advances into the proximal jejunum as clinically indicated. The provider documents visual findings, performs targeted brushing or washing to obtain cytology specimens of suspicious mucosa, and may obtain biopsies through a separate tissue-sampling code if performed. The clinical workflow includes pre-procedure history and consent, sedation and monitoring by nursing and anesthesia staff as indicated, endoscopic inspection and sampling, immediate post-procedure recovery and discharge instructions, and transmission of cytology specimens to the pathology laboratory for analysis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default / no modifier | Use when no specific modifier applies and a single, standard service is reported |