2025 CPT code 45350
Effective Date: N/A Surgery > Surgical Procedures on the Digestive System Feed
Sigmoidoscopy, flexible; with band ligation(s) (e.g., hemorrhoids).
Modifiers may be applicable in certain situations, such as if the procedure is discontinued (modifier 53) or if there are significant additional procedural services requiring modifier 22.
Medical necessity for 45350 is established by the presence of symptomatic hemorrhoids, polyps, or other lesions amenable to band ligation within the reach of a flexible sigmoidoscope.Documentation should support the patient's symptoms and the need for intervention.
The physician prepares the patient, administers anesthesia (if necessary), performs the sigmoidoscopy, identifies and ligates the target structures with bands, and removes the scope.
In simple words: The doctor uses a flexible tube with a camera and light (a sigmoidoscope) to examine your rectum and lower part of your colon. During the exam, they place small rubber bands around hemorrhoids or similar structures to cut off their blood supply, causing them to shrink and fall off.
This procedure involves the application of band ligations to structures like hemorrhoids using a flexible sigmoidoscope. The physician inserts the sigmoidoscope, identifies the target structure, and applies one or more rubber bands to ligate it, cutting off blood supply and causing it to eventually shed.This procedure is distinct from colonoscopy with band ligations (45398). Do not report 45350 in conjunction with 45334 for the same lesion, with 45330, 45349, 46221, or more than once per session. To report control of active bleeding with band ligation(s), use 45334.
Example 1: A patient presents with symptomatic internal hemorrhoids. Flexible sigmoidoscopy with band ligation (45350) is performed to treat the hemorrhoids., During a flexible sigmoidoscopy, a polyp is discovered in the sigmoid colon. Band ligation (45350) is performed to remove the polyp., A patient with recurrent rectal bleeding undergoes flexible sigmoidoscopy. Several small angioectasias are identified and treated with band ligation (45350).
Documentation should include details of the sigmoidoscopy findings (e.g., location and size of hemorrhoids or other lesions), number of band ligations performed, any complications, and post-procedure instructions.
- Specialties:Gastroenterology, General Surgery, Colorectal Surgery.
- Place of Service:Office, Ambulatory Surgical Center, Outpatient Hospital, Inpatient Hospital (if medically necessary).