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2025 CPT code 45338

Flexible sigmoidoscopy with removal of tumor(s), polyp(s), or other lesion(s) by snare technique.

Code 45338 is reported only once per operative session, regardless of the number of lesions removed. If other procedures are performed during the same session, appropriate coding guidelines should be followed for those procedures.

Modifiers such as 22 (Increased Procedural Services), 52 (Reduced Services), and 53 (Discontinued Procedure) may be applicable in certain circumstances.

Medical necessity for 45338 must be supported by documentation of symptoms, positive findings on other diagnostic tests, or a history of conditions that warrant a sigmoidoscopy and removal of lesions.

The physician is responsible for preparing the patient, administering anesthesia (if necessary), inserting and maneuvering the sigmoidoscope, identifying and removing lesions using the snare technique, and ensuring proper documentation of the procedure.

IMPORTANT:Do not report 45338 in conjunction with 45349 for the same lesion. Do not report 45338 in conjunction with 45330. For endoscopic mucosal resection, use 45349.

In simple words: This procedure involves examining your rectum and lower part of your colon with a flexible tube that has a camera. If any abnormal growths (like polyps or tumors) are found, they are removed using a wire loop during the same procedure.

This code describes a procedure where a flexible sigmoidoscope (a thin, flexible tube with a camera) is inserted through the anus to examine the rectum and sigmoid colon. During the procedure, any tumors, polyps, or other lesions found are removed using a snare technique. This involves passing a wire loop over the growth and then severing it from the lining of the colon.

Example 1: A patient presents with rectal bleeding. A flexible sigmoidoscopy is performed, and a polyp is found in the sigmoid colon. The polyp is removed using a snare technique during the procedure. Code 45338 is reported., A patient is undergoing a routine screening flexible sigmoidoscopy. A small tumor is discovered in the rectum. The tumor is removed via snare polypectomy. Code 45338 is reported., A patient with a history of colon cancer is undergoing surveillance. During a flexible sigmoidoscopy, several polyps are identified and removed using a snare technique. Code 45338 is reported.

Documentation should include the size and location of the removed lesion(s), the snare technique used, any complications encountered, and the findings of the sigmoidoscopy.

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