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Official Description

Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Fecal microbiota instillation, as described by CPT® Code 0780T, involves the administration of a fecal microbiota suspension via a rectal enema into the lower gastrointestinal tract. This procedure is primarily indicated for patients suffering from Clostridium difficile infection, a condition characterized by severe diarrhea and colitis caused by the overgrowth of this bacterium. The instillation aims to restore the balance of gut microbiota, which can be disrupted in patients with such infections. Prior to the procedure, it is essential for the patient to empty both the bladder and bowel to ensure optimal conditions for the instillation. The patient is typically positioned on their left side or in a knee-to-chest position to facilitate the procedure. A lubricated rectal enema tube is then carefully inserted, with the opposite end connected to a gravity-fed instillation bag that contains the fecal microbiota suspension. The bag is elevated, allowing gravity to assist in the flow of the suspension into the lower gastrointestinal tract. Following the instillation, the patient is advised to remain in position for approximately 15 minutes to allow for adequate absorption before discharge.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Fecal microbiota instillation is performed for the following indications:

  • Clostridium difficile infection This procedure is specifically indicated for patients diagnosed with Clostridium difficile infection, which can lead to severe gastrointestinal symptoms and complications.

2. Procedure

The procedure for fecal microbiota instillation involves several key steps to ensure proper administration and effectiveness of the treatment.

  • Preparation of the patient Before the procedure begins, the patient must be instructed to empty both the bladder and bowel as thoroughly as possible. This preparation is crucial to create the best conditions for the instillation and to minimize discomfort during the procedure.
  • Positioning The patient is then positioned on their left side or in a knee-to-chest position on the examination table. This positioning helps facilitate the flow of the fecal microbiota suspension into the lower gastrointestinal tract.
  • Insertion of the rectal enema tube A lubricated rectal enema tube is carefully inserted into the rectum. This step requires gentle handling to avoid causing any discomfort or injury to the patient.
  • Connection to the instillation bag The other end of the rectal enema tube is connected to a gravity-fed instillation bag that contains the fecal microbiota suspension. This setup is designed to allow for a controlled and steady flow of the suspension.
  • Instillation of the suspension The instillation bag is then raised, and the flow stop is released to allow the fecal microbiota suspension to be instilled into the lower gastrointestinal tract via gravity. This method ensures that the suspension is delivered effectively.
  • Post-instillation positioning After the suspension has been instilled, the patient is advised to remain in the same position for approximately 15 minutes. This waiting period is important to allow for adequate absorption of the microbiota into the gut before the patient is discharged.

3. Post-Procedure

Following the fecal microbiota instillation, the patient is typically monitored for a short period to ensure there are no immediate adverse reactions. After the 15-minute waiting period, the patient may be discharged with instructions on any necessary follow-up care or monitoring for symptoms related to their Clostridium difficile infection. It is important for the patient to report any unusual symptoms or complications that may arise after the procedure.

Short Descr INSTLJ FECAL MICROBIOTA SSP
Medium Descr INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC
Long Descr Instillation of fecal microbiota suspension via rectal enema into lower gastrointestinal tract
Status Code Carriers Price the Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Not Discounted when Multiple
Berenson-Eggers TOS (BETOS) none
MUE 1
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
JZ Zero drug amount discarded/not administered to any patient
Date
Action
Notes
2023-01-01 Added Code added.
Code
Description
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