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    v1.0.31
    OpenPayerBilling CodesEndoscopic Stomal ProceduresCPT cpt-44392-colonoscopy-through-colostomy-lesion-excision
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    CPT 44392: Colonoscopy via Colostomy Stoma with Polypectomy

    Medicare pays $447 on average nationally for this procedure.

    CPT code 44392 describes a colonoscopic procedure performed through a previously created colostomy stoma to inspect the remaining colon and remove one or more abnormal masses or polyps with a device that grasps, excises, and cauterizes the tissue; the specimen is submitted for pathological analysis. Service type: endoscopic polypectomy via colostomy stoma. Typical site of service: hospital outpatient department or ambulatory surgery center where endoscopic procedures through a colostomy are performed.

    For related coverage guidance, see recent payer policy updates: Diabetic Supplies, Radiofrequency Ablation for Thyroid Nodules, Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with a history of sigmoid colectomy and a permanent colostomy presents for surveillance and evaluation of new bleeding and change in stoma output. The colorectal surgeon schedules a stoma colonoscopy to inspect the remaining colon through the existing colostomy stoma, evaluate mucosa, and remove a suspicious polyp found on prior imaging. The procedure is performed in an outpatient endoscopy suite under monitored anesthesia care with the patient in the supine position. The surgeon introduces a colonoscope through the stoma, advances to visualize the colonic mucosa, identifies a 1.5 cm sessile polyp in the descending colon, performs snare polypectomy with electrocautery, achieves hemostasis, and sends the specimen to pathology for histologic evaluation. Postprocedure recovery includes monitoring for bleeding or perforation, discharge with stoma care instructions, and pathology follow-up.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    45380Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multipleMay be performed when no stoma exists; biopsy-only alternative if polypectomy is not done during stoma colonoscopy
    45385Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare techniqueSimilar therapeutic intent; used when performing polypectomy during standard transanal colonoscopy rather than via a stoma
    43254Esophagogastroduodenoscopy, flexible, diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)May be performed in same encounter for upper GI evaluation in symptomatic patients; different organ system but sometimes bundled into combined endoscopy visit
    88305Surgical pathology, gross and microscopic examinationUsed for histologic evaluation of the polypectomy specimen removed during the stoma colonoscopy
    99152Moderate sedation services provided by the same physician performing the procedure, initial 15 minutesUsed if moderate sedation is documented and billed by the physician performing the procedure

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RC0000X
    208000000X
    207L00000X
    207V00000X
    227900000X
    1744R1102X
    207XX0801X
    207WX0110X

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    C18.9Malignant neoplasm of colon, unspecified
    C19Malignant neoplasm of rectosigmoid junction
    C20Malignant neoplasm of rectum
    C21.8Malignant neoplasm of overlapping sites of rectum, anus and anal canal
    D12.6Benign neoplasm of colon, unspecified
    D12.7Benign neoplasm of rectosigmoid junction
    I85.00Esophageal varices without bleeding
    K50.919Crohn's disease, unspecified, with unspecified complications
    K51.90Ulcerative colitis, unspecified, without complications
    K52.9Noninfective gastroenteritis and colitis, unspecified

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    10 rows

    PolicyPayerEffective Date
    Diabetic SuppliesCigna2026-10-15
    Radiofrequency Ablation for Thyroid NodulesCigna2026-10-15
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Idaho Only)UnitedHealthcare2026-10-01
    Tzield (teplizumab-mzwv) CoverageUnitedHealthcare2026-10-01
    Continuous Glucose Monitoring and Insulin Delivery for Managing Diabetes (for Indiana Only)UnitedHealthcare2026-10-01
    Medical Necessity Guidelines Insulin PumpsMass General Brigham Health Plan2026-10-01
    Medical Necessity Guidelines: Continuous Glucose MonitorsMass General Brigham Health Plan2026-10-01
    Continuous Glucose MonitoringAmbetter Nevada2026-10-01
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01

    Related Codes

    CPT-44380-STOMAL-ILEOSCOPY-ENDOSCOPIC-ILEUM-EXAMINATION

    CPT 44380: Ileoscopy via Stoma with Brushings or Washings

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

    CPT 44381: Ileoscopy via Stoma with Endoscopic Balloon Dilation

    CPT-44382-ILEOSCOPY-THROUGH-STOMA-BIOPSY

    CPT 44382: Ileoscopy Through Stoma with Biopsy

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

    CPT 44384: Ileoscopy with Endoscopic Stent Placement via Stoma

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

    CPT 44385: Endoscopic Evaluation of Ileal Pouch with Brushings/Washings

    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 Through Colostomy Stoma for Evaluation

    CPT-44389-STOMAL-COLONOSCOPY-WITH-BIOPSY

    CPT 44389: Endoscopic Colon Examination Through Stoma with Biopsy

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

    CPT 44390: Colonoscopy via Colostomy for Foreign Body Removal

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

    CPT 44391: Colonoscopy via Colostomy Stoma with Hemostasis

    Showing 1–10 of 19

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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