Summary & Overview
CPT 44705: Donor Stool Screening and Preparation for Instillation
CPT code 44705 covers testing donor stool for bacteria, viruses, and syphilis, followed by preparation of the screened material for instillation. The code captures a specialized process that supports fecal microbiota transplantation (FMT) and other therapeutic instillation procedures relying on screened donor stool. As FMT and related therapies expand, clear coding for donor-screening and preparation is important for accurate clinical documentation and claims processing across payers.
This analysis includes national payer perspectives from Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks on how payers classify and reimburse this preparatory laboratory and processing service, relevant clinical context around donor screening steps, and implications for facility and laboratory billing. The publication also summarizes typical sites of service and the core clinical components embodied by the code.
What readers will learn: an overview of the clinical service represented by CPT code 44705, payer coverage landscape, typical billing and service settings, and the key clinical steps included in the code. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 44705 describes testing donor stool for bacterial, viral, and syphilis pathogens and preparing the screened material for instillation. This service encompasses laboratory testing of donor stool and the preparatory steps required to make the specimen suitable for instillation into a recipient.
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Service Type: Donor stool screening and preparation for instillation
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Typical Site of Service: Hospital laboratory or outpatient clinical laboratory where donor screening and specimen preparation are performed
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Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult with recurrent Clostridioides difficile infection or another microbiome-related condition referred for fecal microbiota transplantation (FMT). The donor stool is obtained from a screened, healthy donor and delivered to the clinical laboratory. The laboratory provider performs comprehensive infectious testing for enteric bacterial pathogens, viral pathogens, and syphilis, documents results, and then prepares the stool specimen into an instillation-ready product (e.g., filtered, aliquoted, suspended) for delivery to the treating clinician. The workflow includes donor screening and consent, laboratory testing (culture, PCR, serology), processing under aseptic conditions, quality control documentation, and labeling for instillation by colonoscopic infusion, nasoenteric tube, or capsule administration. Typical site of service is an outpatient clinical laboratory or hospital-based laboratory associated with a gastroenterology or infectious disease clinic. The typical patient is medically stable but has failed standard antibiotic therapy and is scheduled for FMT by a gastroenterologist; the lab-prepared material is transferred to the procedure suite or outpatient clinic on the day of instillation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient service | Use when the service is the usual, customary service provided in outpatient setting by the reporting provider |