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Gastroenterology Coding Alert

Reader Questions:

Mark Off Similar Proctosigmoidoscopy Codes

Published on Wed Jul 28, 2010

Question:A patient underwent formalin chemical fulguration of rectal mucosa with rigid sigmoidoscopy for radiation proctitis due to pelvic radiation for prostate cancer. The gastroenterologist wanted to stop hemorrhage, and at the same time treat proctitis. I would use 45317 to report the procedure. Could you tell me if I'm right?California SubscriberAnswer:You are not. The code that fits the given scenario is 45320 (Proctosigmoidoscopy with ablation of tumor[s], polyp[s], or other lesion[s] not amenable to removal by hot biopsy forceps, bipolar cautery, or snare technique). However, 45317 could be correct if the patient was actively bleeding at the time of the procedure. CPT 45320 is correct if the patient was not actively bleeding when the procedure was performed. You might mention the RVU values of each code.
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