CPT® Code 44370

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)

The CPT® Code 44370 refers to a specific medical procedure known as small intestinal endoscopy, specifically an enteroscopy that extends beyond the second portion of the duodenum, excluding the ileum. This procedure involves the use of a flexible fiberoptic endoscope, which is a specialized instrument designed for visual examination of the small intestine. The duodenum, which is the first section of the small intestine, is anatomically divided into four distinct portions: the duodenal bulb or cap, the descending portion, the transverse portion, and the ascending portion. During the procedure, the patient is typically administered a local anesthetic spray to numb the throat and mouth, facilitating the insertion of the endoscope. A hollow mouthpiece is utilized to keep the mouth open, allowing for easier passage of the endoscope as the patient swallows it. Once the endoscope is successfully navigated beyond the cricopharyngeal region, it is carefully guided into the duodenum under direct visualization. The physician inspects the mucosal surfaces of the small intestine, extending the examination to areas beyond the second portion of the duodenum, which may include the jejunum, but intentionally excludes the ileum. Any abnormalities observed during this inspection are meticulously documented. If a stenosis, or narrowing, is identified, the area may be predilated to facilitate the placement of a stent. The physician assesses the position and length of the stenosis to select an appropriately sized stent, which is then introduced through the endoscope. The stent is positioned within the narrowed segment of the small intestine and deployed, or expanded, to alleviate the obstruction. Additionally, separate radiographs may be obtained to evaluate the stent's expansion and confirm its proper positioning within the gastrointestinal tract.