Argon Plasma Coagulation

jsf0002

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I'm a little iffy on how to code a specific instance. In one procedure, a polyp was unable to be fully removed via the traditional snare method (45385) and required the doc to finish the removal by ablation via Argon Plasma Coagulation. Would coding the APC as ablation of a tumor, 45388 followed by 45385 with a modifier 59 be appropriate for this instance? Any help or thoughts would be appreciated.

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Venkatakrishnan

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Hi,

In this context, same polyp is tried with snare and partially removed. Remaining portion of the SAME polyp is treated with coagulation.

Since same polyp is tried with two different techniques, we have to code for more invasive one (here ablation 45388).

If we look at the previous description of this CPT code (earlier it was 45383), we can understand the nature of the procedure. It said that NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, BIPOLAR CAUTERY OR SNARE TECHNIQUE.

Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique.

This is how I have understood the code. Let us see, what other friends suggest.

Thanks,
Vernon Kreiss
 
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