Using CPT Codes for Colonoscopy Procedures


There are types of colonoscopy where we have the submucosal injection. We may use this to tattoo an area so that we can lift it up, so that they can see it better or in subsequent
surgery.

So this is an additional technique where we're not actually removing anything but injecting something into it. Notice the injection has a parenthetical S, meaning 1 injection, 2 injections, 10 injections. You can only bill the code once. And we see that for most of these colonoscopy codes.

45382 - Which is control of bleeding. Now, this is bleeding that was not caused by you. This is control of bleeding such as for diverticulitis or diverticulosis. This is not a little bit of bleeding because you excised a polyp but rather a significant amount of bleeding caused by something else.

45383. This is with ablation. Now, this particular one can be misleading because it only states what techniques the code really shouldn't be used for in many of the descriptors. It may not be possible to remove a lesion using one of the techniques or maybe the lesion hasn't been biopsied before but rather is ablated. It is just a catch-all code for some of these types of techniques that are not more specifically defined in your operative report that would allow you to use a code that has a higher number. This is also frequently used to describe for a treatment of benign vascular lesion that they see.

45384 has removal of tumor, parenthetical S, polyp, parenthetical S for other lesions. Parenthetical S so 1, 5, 10 or 100, we can only use this code one time and this is using our hot biopsy forceps or bipolar cautery. And this is where it heats up the metal to help to take that lesion off.

45385 is where we have snare technique. As it says, the snare technique involves the lassoing of the polyp or lesion. Any type of snare techniques, you should use this code. So we have to be careful we have hot biopsy forceps which can have hot snare equipment.

So we want to be sure we use the right code based on the documentation. This is the technique most often used when removing what they call sessile polyps, those that have a large base. And then the ones that are called pedunculated which are caps like a stalk, like a piece of broccoli or something where it surrounds the polyp at the bottom and then it just severs it right off. You know, lasso just like it sounds, is what cowboys would do.

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