# Fecal Transplants



## Missdeb56@comcast.net (Nov 4, 2011)

Is anyone billing for fecal transplants. I am not sure if it would go as an unlisted procedure with the dictation to support it or if this is billed as a 45378. Any info. would be greatly appreciated.


----------



## colorectal surgeon (Nov 4, 2011)

I would code the colonoscopy portion as 45378.

However, there must be some other codes for preparation of the 'transplant'. I don't know about that. Not looking forward to talking to patients about it though!


----------



## bridgettemartin (Nov 7, 2011)

We use 44799.

Bridgette Martin LPN, CPC, CGIC


----------



## SM6489 (Apr 4, 2012)

Can I ask how much you charge for that? We are new to this and since the coding for this is unlisted, there is no information in our fee analyzer on what to charge.

Thanks.


----------



## bridgettemartin (Apr 5, 2012)

We were just talking about this yesterday, as we had another fecal transplant.  That was a Medicare patient and they only paid $10 more than a 45378. I can tell you the one I just coded yesterday, we decided to just use 45378.  That decision was based on the documentation, and the fact it was a Medicare patient.


----------



## colorectal surgeon (Apr 6, 2012)

I've heard about plenty of codes for colonoscopy and removing things but never one for colonoscopy and putting something in!

I'd be careful about discussions of exact amount of charges as the feds can apparently get you for price fixing.  I know it's crazy.


----------



## cleon@uspi.com (Sep 26, 2012)

*Fecal transplants*

Does anyone have current information on fecal transplants? Any information on this would be greatly appreciated!!! Thanks


----------



## JDHumenay (Oct 26, 2012)

*Updated info on FMT*

In 2013, they will be adding CPT 44703 to meet this criteria. No word yet on if CMS will cover it.


----------



## swansm (Feb 27, 2013)

*Here is the new code*

The code is 44705. "Preparation of fecal microbiota for installation, including assessment of donor specimen." So you would first code the colonoscopy 45378 then the 44705.


----------



## njkonzem@yahoo.com (Mar 7, 2013)

Our facility is doing fecal transplants but they are inserting it with an NG tube.  Any ideas of how to code?  In looking around it's kind of looking like 44799, but then what price do you use or G0455.  Thoughts?


----------



## bridgettemartin (Mar 8, 2013)

njkonzem@yahoo.com said:


> Our facility is doing fecal transplants but they are inserting it with an NG tube.  Any ideas of how to code?  In looking around it's kind of looking like 44799, but then what price do you use or G0455.  Thoughts?



From what I understand, G0455 is for any method.  Under 44705 in the CPT book, it directs you to use 44799 for oro-nasogastric tube or enema.  44705 includes the assessment of the donor specimen.  I also understand there to be separate codes the lab uses to test the donor. 
There is still some question, however, as to who gets to report G0455. Medicare states G0455 can only be reported once, and only if the transplant takes place.  So, what happens if one provider assesses the patient and orders the fecal transplant and another provider prepares the specimen and instills it?
I've pasted an excerpt from a letter drafted to CMS from the AGA and ASGE.

"Referring to the preparation of the microbiota, there is extensive physician work involved in determining whether a patient is a suitable candidate for fecal donation. This preparation work must take into account recent antibiotic use, travel, transmissible pathogens, and immunodeficiency disease that relate to the potential donor. Once the microbiota is prepared, the microbiota then needs to be instilled. There may be occasions where the work related to instillation of the microbiota may need to be performed by a second health professional, such as a gastroenterologist or surgeon, where clinical circumstances dictate that upper or lower endoscopy is required to instill the fecal donation (e.g. patient who is unable to retain a retention enema). In instances where the preparation is performed by one healthcare professional (Infectious Disease, Primary Care) and the installation by another (Gastroenterology, Surgeon), by bundling the payment for the preparation and installation, this results in a situation where one physician will receive payment for his/her services as well as for those services provided by the other physician."


----------



## vickiete (Mar 28, 2013)

*fecal transplants for Medicare Patients*

My physician is wanting to do fecal transplants on Medicare patients.However, we are being told he cannot charge the 45378 with the NEW G code that Medicare has assigned for this year.  My physician does a colonoscopy to the cecum and then does the stool transplant.  I am desperately trying to find some supportive literature from a Medicare source that says he can charge the 45378 in addition to the new G code.  We are located in North Carolina.  Any help that I could get would be greatly appreciated.


----------



## njkonzem@yahoo.com (Apr 2, 2013)

Thank you for the information.  People higher up are sitll working on figuring out how to code/bill for this.  I guess it's a special billing issue at our facility.


----------

