Deb - you are coding these correctly, as previously stated by Anna and Leslie. Per CPT Assistant Jan 2004 Colonoscopy coding made simple:
Snare devices may also be used without electrocautery to “decapitate” small polyps. Most often the colonoscopy report will specify that a “snare technique” was used. But do not let alternative terminology throw you off. The report may also include the phrase “hot snare,” “monopolar snare,” “cold snare,” or “bipolar snare,” all of which should be reported using code 45385.
CPT code 45380, Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple, does not describe a specific technique. The terminology is accepted and understood by colonoscopists to mean the use of a forceps to grasp and remove a small piece of tissue without the application of cautery. Colonoscopy reports may describe the biopsy of a lesion or polyp using a cold forceps or may describe the biopsy without mentioning the specific device. The biopsy may be from an obvious lesion that is too large to remove, from a suspicious area of abnormal mucosa, or from a lesion or polyp so small that it can be completely removed during the performance of the biopsy, which is often demonstrated with the cold biopsy forceps technique. The technique is the same and the service is reported with code 45380 regardless of the final histology of the piece of tissue obtained for analysis. Colonoscopy with removal by snare technique, 45385, should not be used for a report describing the removal of a small polyp by “biopsy” or “cold forceps” technique.
