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The CPT® Code 45190 refers to the procedure for the destruction of a rectal tumor using a transanal approach. This procedure encompasses various techniques such as electrodesiccation, electrosurgery, laser ablation, laser resection, and cryosurgery. In this context, the term "destruction" indicates the removal or eradication of the tumor through different methods that utilize heat, cold, or other forms of energy. The transanal approach involves accessing the rectal area through the anus, allowing for direct visualization and treatment of the tumor. During the procedure, the sphincter is carefully stretched, and anal retractors are applied to provide a clear view of the tumor. The lesion is thoroughly examined to determine the most suitable method of destruction. Techniques such as injecting saline or epinephrine into the submucosa beneath the tumor may be employed to elevate the lesion and minimize bleeding during the procedure. The area designated for destruction includes not only the tumor itself but also a margin of healthy tissue surrounding it to ensure complete removal. Each destruction method has its specific mechanism: electrodessication utilizes a high-frequency electric current to destroy the tumor, while electrosurgery applies heat through a metal probe or needle. Laser ablation employs a laser to vaporize the tumor, and laser resection involves excising the tumor with a CO2 laser. Cryosurgery, on the other hand, involves freezing the lesion with liquid nitrogen, often requiring multiple freeze-thaw cycles to achieve complete destruction. This comprehensive approach to tumor destruction is critical for effective treatment and management of rectal tumors.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 45190 is indicated for the treatment of rectal tumors. The specific indications for performing this procedure include:
The procedure for the destruction of a rectal tumor using a transanal approach involves several critical steps, which are detailed as follows:
After the procedure, patients may require monitoring for any immediate complications, such as bleeding or infection. Post-procedure care typically includes pain management and instructions for wound care if applicable. Patients may also be advised on dietary modifications and activity restrictions to promote healing. Follow-up appointments are essential to assess recovery and ensure that the tumor has been adequately treated, with additional interventions considered if necessary.
| Short Descr | DESTRUCTION RECTAL TUMOR | Medium Descr | DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH | Long Descr | Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 95 - Other non-OR lower GI therapeutic procedures |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | SG | Ambulatory surgical center (asc) facility service | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2011-01-01 | Changed | Short description changed. Guideline information changed. |
| 2008-01-01 | Changed | Code description changed. |
| 2002-01-01 | Changed | Code description changed. |
| 1995-01-01 | Added | First appearance in code book in 1995. |
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