CPT 44378: Upper GI Endoscopy with Bleeding Control - OpenPayer

Summary & Overview

CPT 44378: Upper GI Endoscopy with Bleeding Control

CPT code 44378 represents an upper gastrointestinal endoscopic exam with therapeutic intervention for bleeding control. This combined diagnostic and treatment procedure is performed with a lighted endoscope to inspect the upper digestive tract from the esophagus through the ileum, identify bleeding sources, and apply endoscopic hemostatic techniques. Nationally, procedures that both diagnose and treat GI bleeding are clinically significant due to their impact on patient outcomes, potential for preventing surgery, and implications for hospital resource use and endoscopy capacity.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 44378, benchmarks where available, common billing considerations, and any notable policy or coverage updates that affect reimbursement and site-of-service decisions. The publication also explains typical settings for the service, coding relationships, and operational implications for hospitals and ambulatory surgical centers.

This summary is intended for revenue cycle professionals, clinicians involved in endoscopy services, and policy analysts seeking a national perspective on coding, clinical use, and payer considerations for endoscopic GI bleeding control.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44378endoscopyupper gastrointestinalgastroenterologyhemostasisendoscopic therapyprocedural codinghospital servicesambulatory surgical center

Billing Code Overview

CPT code 44378 describes a diagnostic and therapeutic upper gastrointestinal endoscopic procedure in which the provider performs a visual examination of the upper digestive tract using a lighted endoscope, inspects from the esophagus through the stomach and into the ileum to identify bleeding sources, and applies techniques to control bleeding. This is an endoscopic hemorrhage control procedure combining visualization and therapeutic intervention.

Service type: Endoscopic upper gastrointestinal diagnostic and therapeutic procedure
Typical site of service: Hospital operating room, endoscopy suite, or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A 58-year-old male presents to the emergency department with acute onset melena and lightheadedness. He has a history of chronic NSAID use for osteoarthritis and chronic alcohol use. Hemoglobin is 7.8 g/dL and vital signs show transient orthostatic hypotension. After initial resuscitation with IV fluids and transfusion as needed, the gastroenterology team performs an urgent diagnostic and therapeutic upper endoscopy using a lighted endoscope to evaluate the entire upper gastrointestinal tract from esophagus to ileum for active bleeding. During the procedure the endoscopist identifies a bleeding duodenal ulcer and applies endoscopic hemostatic techniques (injection of epinephrine, thermal coagulation, and placement of endoscopic clips). The typical workflow includes pre-procedure consent and review of anticoagulation status, sedation or anesthesia evaluation (conscious sedation or monitored anesthesia care), the procedure in an endoscopy suite or operating room, post-procedure recovery with monitoring for rebleeding, and documentation of findings and therapeutic maneuvers performed.

Coding Specifications

Modifier	Description	When to Use
`11`	Unusual procedural service	Use when the service is greater than normally required — e.g., significantly prolonged or complex endoscopic hemostasis beyond typical scope of `44378`.

CPT 44369: Endoscopic Laser/Radiofrequency Ablation of Upper Small Bowel Lesions

CPT-44379-UPPER-ENDOSCOPY-WITH-DILATION-AND-STENT-PLACEMENT

CPT 44379: Upper Endoscopy with Dilation and Stent Placement

CPT-44376-DIAGNOSTIC-UPPER-ENDOSCOPY-BRUSHING-LAVAGE

CPT 44376: Diagnostic Upper GI Endoscopy with Brushing or Lavage

CPT-44363-ENDOSCOPIC-JEJUNAL-INTUBATION-FOREIGN-BODY-REMOVAL

CPT 44363: Endoscopic Examination and Foreign-Body Removal, Proximal Small Intestine

CPT-44377-UPPER-GI-ENDOSCOPY-WITH-BIOPSY

CPT 44377: Upper Gastrointestinal Endoscopy with Biopsy

CPT-44361-ENDOSCOPY-PROXIMAL-SMALL-INTESTINE-BIOPSY

CPT 44361: Endoscopic Examination of Proximal Small Intestine with Biopsy

CPT-44366-UPPER-SMALL-BOWEL-ENDOSCOPY-HEMOSTASIS

CPT 44366: Upper Small Bowel Endoscopy with Hemostasis

CPT-44364-SMALL-BOWEL-ENDOSCOPY-SNARE-POLYPECTOMY

CPT 44364: Small-Bowel Endoscopy with Snare Lesion Removal

CPT-44373-GASTROSTOMY-TO-JEJUNOSTOMY-CONVERSION-ENDOSCOPIC

CPT 44373: Endoscopic Conversion of Gastrostomy to Jejunostomy

CPT-44365-SMALL-INTESTINE-ENDOSCOPY-LESION-REMOVAL

CPT 44365: Small Intestine Endoscopy with Lesion Removal

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Taxonomy Code	Specialty	Notes
`350500000X`	Gastroenterology	Physicians who commonly perform diagnostic and therapeutic upper endoscopy and hemostasis.
`207RC0000X`	Colon & Rectal Surgery	Surgeons who may perform endoscopic or surgical management of GI bleeding when indicated.
`207L00000X`	Anesthesiology	Providers who may provide monitored anesthesia care or general anesthesia for complex or high-risk endoscopic procedures.
`208D00000X`	General Surgery	Surgeons involved when endoscopic therapy fails and operative management is required.
`207K00000X`	Internal Medicine	Hospitalists or intensivists involved in medical stabilization and peri-procedural care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K25.0`	Acute gastric ulcer with hemorrhage	Peptic ulcer disease with bleeding is a common indication for upper endoscopic hemostasis.
`K26.0`	Acute duodenal ulcer with hemorrhage	Duodenal ulcers frequently cause upper GI bleeding requiring endoscopic control.
`K92.2`	Gastrointestinal hemorrhage, unspecified	Used when source of bleeding is not yet localized; endoscopy is performed diagnostically and therapeutically.
`I85.01`	Esophageal varices with bleeding	Variceal hemorrhage requires urgent endoscopic evaluation and variceal band ligation or sclerotherapy.
`K29.01`	Acute hemorrhagic gastritis	Inflammatory bleeding of the stomach treated or evaluated with endoscopy and hemostatic techniques.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43235`	Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum; diagnostic, with or without collection of specimen(s)	Diagnostic upper endoscopy often performed when bleeding source is suspected; may be billed when no therapeutic hemostasis is performed or when separate diagnostic scope precedes therapy.
`43255`	Upper gastrointestinal endoscopy with control of bleeding, any method	Alternate endoscopic code for control of bleeding in the upper GI tract; used for specific therapeutic maneuvers depending on CPT guidance and anatomy.
`43239`	Upper gastrointestinal endoscopy, flexible, transoral; with biopsy, single or multiple	Performed when biopsies are obtained during the endoscopic evaluation of a bleeding lesion.
`43840`	Laparoscopic repair of perforation of gastroduodenal ulcer, with or without vagotomy	Surgical code representing operative management when endoscopic therapy fails and surgery is required for complications such as perforation.
`43254`	Upper gastrointestinal endoscopy with gastric dilation	Performed when dilation is needed for associated strictures encountered during evaluation; may be adjunctive to bleeding control if indicated.
`91110`	Chromoendoscopy or application of hemostatic agent (injectable) (example procedural adjunct)	Represents therapeutic adjuncts used during endoscopic hemostasis; billed separately only when supported by payer policy and documentation.

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