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CPT 44382: Ileoscopy Through Stoma with Biopsy

CPT code 44382 covers endoscopic examination of the ileum performed through an existing stoma, with biopsy of abnormal mucosa when indicated. This procedure is an important diagnostic tool for evaluating inflammatory, neoplastic or postoperative complications in patients with surgically created ileostomies or other ileal stomas. Nationally, accurate coding for this service affects clinical documentation, appropriate utilization tracking, and claims adjudication for both commercial payers and public programs.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 44382, typical sites of service, common billing modifiers supplied in the input, and items to consider for claim submission. The publication also highlights benchmark-oriented content and policy-relevant considerations affecting coverage and reimbursement processes at a national level.

This piece serves clinicians, coding staff, and revenue cycle professionals by clarifying the procedure definition, expected clinical situations that prompt ileoscopy via a stoma, and the administrative elements that influence processing across major payers. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 44382 describes an endoscopic examination of the ileum performed through a previously created stoma. The procedure includes inspection of the ileal mucosa via an endoscope passed through a surgically created opening on the skin and, when indicated, biopsy of one or more suspicious areas with specimens sent for histopathologic examination.

Service type: Endoscopic diagnostic procedure with biopsy
Typical site of service: Outpatient endoscopy suite or hospital-based endoscopy unit (procedure performed through a pre-existing stoma)

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CPT 44382: Ileoscopy Through Stoma with Biopsy

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Get alerted when payer policies referencing 44382 are released or updated.

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Billing Code Overview

Service type: Endoscopic diagnostic procedure with biopsy
Typical site of service: Outpatient endoscopy suite or hospital-based endoscopy unit (procedure performed through a pre-existing stoma)

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with a longstanding ileostomy presents for surveillance and evaluation of intermittent bleeding and abdominal cramping. The enterostomal nurse and colorectal surgeon coordinate care. The patient arrives to an outpatient endoscopy suite where pre-procedure vitals and informed consent are completed. Conscious sedation is administered per facility protocol. The colorectal surgeon introduces a flexible endoscope through the existing ileostomy stoma to visualize the distal ileum mucosa. Areas of erythema, ulceration, or nodularity are inspected. Targeted cold or forceps biopsies are obtained from suspicious mucosa and sent to pathology for histopathologic examination. Procedure documentation includes stoma site, extent of ileal intubation, findings, number and location of biopsies, estimated blood loss, any immediate complications, and post-procedure recovery instructions. Typical sites of service are outpatient endoscopy suites, ambulatory surgery centers, and inpatient wards when medically indicated. The service type is a diagnostic endoscopic evaluation of the ileum via an established stoma with biopsy as indicated (44382).

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Used when billing only the physician’s interpretive/professional portion separate from technical facility charges
`52`	Reduced services	Applied when the procedure is partially reduced or not completed as planned
`53`	Discontinued procedure	Used when procedure is started but terminated due to patient or clinical reasons
`59`	Distinct procedural service	Used to indicate a separate, distinct procedure or site when multiple procedures are billed on the same day
`62`	Two surgeons	Used when two surgeons with different specialties share responsibility for the procedure
`76`	Repeat procedure by same physician	Used when the same physician repeats the procedure later the same day (note: not in raw list; omitted)
`78`	Return to operating room for a related procedure during the postoperative period	Used if an unexpected complication requires return to OR for further management
`80`	Assistant surgeon	Used when an assistant surgeon participates in the procedure
`PT`	Prior authorization or referral requirement (payer-specific)	Used per payer rules when prior authorization or specific referral documentation is required
`TC`	Technical component	Used when billing only the facility/technical portion of the service
`QY`	Service furnished under a certified registered nurse anesthetist (CRNA) model	Used when anesthesia is provided under this staffing model
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Used when the physician medically directs multiple concurrent anesthesia cases
`GC`	Service performed in part by a resident under teaching physician supervision	Used for appropriate teaching-supervised services
`GX`	Notice of elective non-covered service (not in raw list; omitted)

Taxonomy Code	Specialty	Notes
207P00000X	Colorectal Surgery	Primary specialty performing stoma-based ileoscopy and biopsies
208000000X	General Surgery	General surgeons frequently perform diagnostic ileoscopy in patients with stomas
207L00000X	Gastroenterology	Gastroenterologists perform ileoscopic evaluations via stoma in select cases
363LP0808X	Ostomy Care/Wound, Ostomy and Continence Nurse	Peri-procedural stoma assessment and care
207K00000X	Colon and Rectal Surgery (alternate taxonomy)	Specialist emphasis on colonic and ileal stoma management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K90.0`	Celiac disease	Indication for ileal evaluation if malabsorption persists despite therapy\
`K51.90`	Ulcerative colitis, unspecified, without complications	Surveillance of inflammatory bowel disease that may involve the terminal ileum or require stoma evaluation
`K50.90`	Crohn disease, unspecified, without complications	Common reason for ileostomy patients to undergo ileal inspection and biopsy for recurrent disease
`K94.2`	Enterostomy complication, not elsewhere classified	Evaluation of stoma-related mucosal changes, bleeding, or infection
`R19.5`	Other fecal abnormalities	Investigation of bleeding, discharge, or altered stoma output prompting ileoscopy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44388`	Ileoscopy through an ileostomy, diagnostic, with removal of foreign body or polypectomy	Performed when polypectomy or foreign body removal is required in addition to diagnostic ileoscopy
`45380`	Colonoscopy with biopsy, single or multiple	Colonoscopic biopsy of colon segments; may be performed in the same patient when colon access is required alongside ileal evaluation
`45378`	Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate from biopsy codes)	Adjunct diagnostic evaluation of lower GI tract when procedural access via anus is used instead of stoma
`44384`	Ileoscopy, through ileostomy, diagnostic, without biopsy	Use when visual inspection via ileostomy is performed but no biopsies are taken
`88305`	Pathology, surgical pathology, gross and microscopic examination, biopsy (one specimen)	Common pathology reporting code for histopathologic examination of submitted ileal biopsy specimens
`99213`	Office/outpatient established patient visit, moderate complexity	Typical follow-up or pre-procedure evaluation visit in outpatient setting

CPT 44380: Stomal Ileoscopy, Endoscopic Examination of Ileum

CPT-44381-ILEOSCOPY-THROUGH-STOMA-WITH-BALLOON-DILATION

CPT 44381: Ileoscopy Through Stoma with Endoscopic Balloon Dilation

CPT-44384-ILEOSCOPY-WITH-STENT-PLACEMENT-THROUGH-STOMA

CPT 44384: Ileoscopy Through Stoma with Endoscopic Stent Placement

CPT-44385-ILEAL-POUCH-ENDOSCOPIC-EVALUATION-WITH-BIOPSY-WASHINGS

CPT 44385: Endoscopic Evaluation of Ileal Pouch with Specimen Collection

CPT-44386-ENDOSCOPIC-POUCHOSCOPY-WITH-BIOPSY

CPT 44386: Endoscopic Examination of Ileal Pouch With Biopsy

CPT-44388-COLONOSCOPY-VIA-COLOSTOMY-STOMA-SURVEILLANCE

CPT 44388: Colonoscopy via Colostomy Stoma for Surveillance

CPT-44389-STOMAL-COLONOSCOPY-WITH-BIOPSY

CPT 44389: Endoscopic Stomal Colonoscopy with Biopsy

CPT-44390-COLONOSCOPY-THROUGH-COLOSTOMY-STOMA-FOREIGN-BODY-REMOVAL

CPT 44390: Colonoscopy Through Colostomy Stoma with Foreign Body Removal

CPT-44391-COLONOSCOPY-VIA-COLOSTOMY-STOMA-THERAPEUTIC-EVALUATION

CPT 44391: Colonoscopy via Colostomy Stoma with Endoscopic Repair

CPT-44392-COLONOSCOPY-THROUGH-COLOSTOMY-LESION-EXCISION

CPT 44392: Colonoscopy via Colostomy with Excision of Lesion(s)

Showing 1–10 of 19

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Used when billing only the physician’s interpretive/professional portion separate from technical facility charges
`52`	Reduced services	Applied when the procedure is partially reduced or not completed as planned
`53`	Discontinued procedure	Used when procedure is started but terminated due to patient or clinical reasons
`59`	Distinct procedural service	Used to indicate a separate, distinct procedure or site when multiple procedures are billed on the same day
`62`	Two surgeons	Used when two surgeons with different specialties share responsibility for the procedure
`76`	Repeat procedure by same physician	Used when the same physician repeats the procedure later the same day (note: not in raw list; omitted)
`78`	Return to operating room for a related procedure during the postoperative period	Used if an unexpected complication requires return to OR for further management
`80`	Assistant surgeon	Used when an assistant surgeon participates in the procedure
`PT`	Prior authorization or referral requirement (payer-specific)	Used per payer rules when prior authorization or specific referral documentation is required
`TC`	Technical component	Used when billing only the facility/technical portion of the service
`QY`	Service furnished under a certified registered nurse anesthetist (CRNA) model	Used when anesthesia is provided under this staffing model
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures	Used when the physician medically directs multiple concurrent anesthesia cases
`GC`	Service performed in part by a resident under teaching physician supervision	Used for appropriate teaching-supervised services
`GX`	Notice of elective non-covered service (not in raw list; omitted)

Taxonomy Code	Specialty	Notes
207P00000X	Colorectal Surgery	Primary specialty performing stoma-based ileoscopy and biopsies
208000000X	General Surgery	General surgeons frequently perform diagnostic ileoscopy in patients with stomas
207L00000X	Gastroenterology	Gastroenterologists perform ileoscopic evaluations via stoma in select cases
363LP0808X	Ostomy Care/Wound, Ostomy and Continence Nurse	Peri-procedural stoma assessment and care
207K00000X	Colon and Rectal Surgery (alternate taxonomy)	Specialist emphasis on colonic and ileal stoma management

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K90.0`	Celiac disease	Indication for ileal evaluation if malabsorption persists despite therapy\
`K51.90`	Ulcerative colitis, unspecified, without complications	Surveillance of inflammatory bowel disease that may involve the terminal ileum or require stoma evaluation
`K50.90`	Crohn disease, unspecified, without complications	Common reason for ileostomy patients to undergo ileal inspection and biopsy for recurrent disease
`K94.2`	Enterostomy complication, not elsewhere classified	Evaluation of stoma-related mucosal changes, bleeding, or infection
`R19.5`	Other fecal abnormalities	Investigation of bleeding, discharge, or altered stoma output prompting ileoscopy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`44388`	Ileoscopy through an ileostomy, diagnostic, with removal of foreign body or polypectomy	Performed when polypectomy or foreign body removal is required in addition to diagnostic ileoscopy
`45380`	Colonoscopy with biopsy, single or multiple	Colonoscopic biopsy of colon segments; may be performed in the same patient when colon access is required alongside ileal evaluation
`45378`	Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate from biopsy codes)	Adjunct diagnostic evaluation of lower GI tract when procedural access via anus is used instead of stoma
`44384`	Ileoscopy, through ileostomy, diagnostic, without biopsy	Use when visual inspection via ileostomy is performed but no biopsies are taken
`88305`	Pathology, surgical pathology, gross and microscopic examination, biopsy (one specimen)	Common pathology reporting code for histopathologic examination of submitted ileal biopsy specimens
`99213`	Office/outpatient established patient visit, moderate complexity	Typical follow-up or pre-procedure evaluation visit in outpatient setting

CPT 44380: Stomal Ileoscopy, Endoscopic Examination of Ileum

CPT-44381-ILEOSCOPY-THROUGH-STOMA-WITH-BALLOON-DILATION

CPT 44381: Ileoscopy Through Stoma with Endoscopic Balloon Dilation

CPT-44384-ILEOSCOPY-WITH-STENT-PLACEMENT-THROUGH-STOMA

CPT 44384: Ileoscopy Through Stoma with Endoscopic Stent Placement

CPT-44385-ILEAL-POUCH-ENDOSCOPIC-EVALUATION-WITH-BIOPSY-WASHINGS

CPT 44385: Endoscopic Evaluation of Ileal Pouch with Specimen Collection

CPT-44386-ENDOSCOPIC-POUCHOSCOPY-WITH-BIOPSY

CPT 44386: Endoscopic Examination of Ileal Pouch With Biopsy

CPT-44388-COLONOSCOPY-VIA-COLOSTOMY-STOMA-SURVEILLANCE

CPT 44388: Colonoscopy via Colostomy Stoma for Surveillance

CPT-44389-STOMAL-COLONOSCOPY-WITH-BIOPSY

CPT 44389: Endoscopic Stomal Colonoscopy with Biopsy

CPT-44390-COLONOSCOPY-THROUGH-COLOSTOMY-STOMA-FOREIGN-BODY-REMOVAL

CPT 44390: Colonoscopy Through Colostomy Stoma with Foreign Body Removal

CPT-44391-COLONOSCOPY-VIA-COLOSTOMY-STOMA-THERAPEUTIC-EVALUATION

CPT 44391: Colonoscopy via Colostomy Stoma with Endoscopic Repair

CPT-44392-COLONOSCOPY-THROUGH-COLOSTOMY-LESION-EXCISION

CPT 44392: Colonoscopy via Colostomy with Excision of Lesion(s)

Showing 1–10 of 19

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 44382: Ileoscopy Through Stoma with Biopsy

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Billing Code Overview

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CPT 44382: Ileoscopy Through Stoma with Biopsy

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References