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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j1440-fecal-microbiota-live-jslm-1ml
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    HCPCS Level II J1440: Fecal Microbiota, Live - jslm, 1 ml

    HCPCS Level II code J1440 represents a unit of fecal microbiota, live - jslm, 1 ml, used for billing administration of a microbiota-based biologic product typically delivered as an instillation or transplant procedure; the service type is microbiota transplantation/biologic therapeutic administration, and the typical site of service is an outpatient infusion/ambulatory procedure or clinic setting where biologic instillations are performed.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with recurrent Clostridioides difficile infection (rCDI) or other indications for fecal microbiota transplantation (FMT) who has failed standard antibiotic therapy. The patient presents to a gastroenterology clinic or ambulatory infusion center for delivery of microbiota therapy derived from screened donor material. The clinical workflow begins with referral from the primary care provider or infectious disease specialist, donor-screened product acquisition and verification, informed consent, pre-procedure medication reconciliation (including holding offending antibiotics), and bowel preparation or colonoscopic planning if delivery will be endoscopic. Administration of J1440 (fecal microbiota, live - jslm, 1 ml) may occur via colonoscopic instillation, nasoenteric tube, enema, or encapsulated oral formulations dispensed by the pharmacy for outpatient ingestion, depending on the formulation and clinical judgment. Typical sites of service include an ambulatory surgical center, hospital outpatient department, endoscopy suite, infusion center, or outpatient clinic pharmacy for dispensation of oral capsules. Monitoring includes a short post-procedure observation period for immediate adverse reactions and scheduled follow-up to assess resolution of infection and potential delayed adverse events.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    45355Colonoscopy, flexible; with biopsy, single or multipleOften performed immediately before or during endoscopic instillation of the fecal microbiota product for direct colonic delivery
    44705Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washingMay be used when altered anatomy requires stoma-based access for instillation of microbiota material
    43239Esophagogastroduodenoscopy (EGD) with biopsy, single or multipleUsed when upper GI endoscopic placement of a nasoenteric tube or gastric instillation is planned prior to product delivery
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourApplicable if procedural sedation or IV therapies are administered during the delivery visit (billing for infusion time)
    99152Moderate sedation services provided by the physician or other qualified health care professionalBilled when moderate sedation is provided by the endoscopist during colonoscopic delivery of the product

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…
    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 CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    225CA2400XAssistive Technology Practitioner Rehabilitation CounselorRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Rehabilitation Counselor
    247ZC0005XClinical Laboratory Director (Non-physician)An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments o…
    211D00000XPodiatric AssistantAn individual who assists a podiatrist in tasks, such as exposing and developing x-rays; taking and recording patient histories; assisting in biomecha…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    A04.8Other specified bacterial intestinal infections
    A04.9Bacterial intestinal infection, unspecified
    A07.2Cryptosporidiosis
    A08.4Viral intestinal infection, unspecified
    A09Infectious gastroenteritis and colitis, unspecified
    A41.9Sepsis, unspecified organism
    B94.8Sequelae of other specified infectious and parasitic diseases
    K52.9Noninfective gastroenteritis and colitis, unspecified
    K57.20Diverticulitis of large intestine with perforation and abscess without bleeding
    K57.30Diverticulosis of large intestine without perforation or abscess without bleeding

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    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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