2025 CPT code 45349
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Rectum Surgery Feed
Flexible sigmoidoscopy with endoscopic mucosal resection.
Modifiers may apply depending on the circumstances of the procedure (e.g., modifier 52 for reduced services, 53 for discontinued procedure).
Medical necessity for this procedure would be established through the presence of a clinically significant lesion in the rectum or sigmoid colon requiring resection for diagnostic or therapeutic purposes. This could include symptoms such as rectal bleeding, changes in bowel habits, abdominal pain, or the presence of a suspicious polyp.
The physician or qualified endoscopist is responsible for the entire procedure, from patient preparation and anesthesia administration to insertion of the sigmoidoscope, lesion identification and resection, hemostasis, and post-procedure care.
In simple words: The doctor uses a thin, flexible tube with a camera (sigmoidoscope) to look inside the rectum and sigmoid colon (part of the large intestine). If they find an abnormal area (lesion), they remove a small piece of tissue (mucosal resection) to check it or treat the problem.
This CPT code encompasses a flexible sigmoidoscopy procedure involving the resection of mucosal tissue.The procedure uses a flexible sigmoidoscope to visualize the rectum and sigmoid colon. After identifying a lesion, a submucosal injection may be administered to elevate the lesion for easier resection using a snare or other suitable method.Hemostasis is ensured after the excision.This code is for diagnostic or therapeutic purposes. Note that this code should not be reported with codes 45331, 45335, 45338, 45350, or 45330 for the same lesion.
Example 1: A patient presents with rectal bleeding and a suspicious polyp identified during a prior exam. The physician performs a flexible sigmoidoscopy with endoscopic mucosal resection of the polyp to obtain a tissue sample for biopsy and to potentially remove the polyp if benign., A patient experiences chronic constipation and abdominal discomfort.A flexible sigmoidoscopy with EMR is performed to rule out any underlying lesions, such as polyps, that could be contributing to these symptoms., During a routine colonoscopy, a small lesion is found in the sigmoid colon. The physician decides to proceed with a flexible sigmoidoscopy with EMR to remove the lesion for diagnostic and therapeutic purposes, potentially avoiding a more extensive surgical intervention.
** Always refer to the most current CPT codebook and payer guidelines for accurate coding and reimbursement practices.Specific details regarding the global period and relative value units should be verified with the relevant payer.
- Revenue Code: P8C (Endoscopy - Sigmoidoscopy)
- RVU: This information is not provided and requires consultation with the payer's fee schedule or a medical billing resource.
- Global Days: Global period information is not explicitly stated for this code.Further research into the payer's guidelines and the specific details of the procedure performed would be necessary to determine the appropriate global period.
- Payment Status: Active
- Modifier TC rule: The information on whether a Technical Component (TC) modifier applies is not specified for this code and requires further research into payer guidelines and coding conventions.
- Fee Schedule: Historical fee schedule data is not available within the provided source and would need to be obtained from reliable medical billing databases or fee schedules from relevant payers.
- Specialties:Gastroenterology, Colorectal Surgery, General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)