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A flexible colonoscopy is a diagnostic and therapeutic procedure that involves the insertion of a colonoscope, a long, flexible tube equipped with a camera and light, into the rectum and advancing it through the colon. This specific procedure, identified by CPT® Code 45383, is performed proximal to the splenic flexure, which is the bend in the colon located near the spleen. The primary purpose of this procedure is to address tumors, polyps, or other lesions that cannot be removed using standard techniques such as hot biopsy forceps, bipolar cautery, or snare technique. Instead, ablation is employed, which refers to the destruction of the lesion using alternative methods, such as laser ablation. During the procedure, the colon is thoroughly examined for any signs of disease or injury, and once a lesion is identified, the ablation technique is applied. This process involves delivering a laser device through the endoscope to the lesion's proximal margin and systematically ablating the lesion as the endoscope is retracted, ensuring complete destruction of the targeted tissue. This procedure is crucial for managing lesions that pose a risk of malignancy or other complications, providing a minimally invasive option for treatment while allowing for thorough visualization of the colon's interior.
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The procedure described by CPT® Code 45383 is indicated for the following conditions:
The procedure begins with the patient being positioned appropriately for a colonoscopy. The colonoscope is then inserted into the rectum and carefully advanced through the colon to a point proximal to the splenic flexure. This allows for a thorough examination of the colon's interior. During this examination, the physician looks for any abnormalities, such as tumors, polyps, or other lesions. Once a lesion is identified, the next step involves determining the appropriate method for treatment. In cases where the lesion cannot be removed using hot biopsy forceps or bipolar cautery, the physician will proceed with ablation. This may involve the use of a laser device, which is introduced through the endoscope. The laser is positioned at the proximal margin of the lesion, and as the endoscope is retracted, the laser is activated to ablate the lesion. This technique ensures that the entire lesion is treated effectively, minimizing the risk of leaving residual tissue behind. The procedure is performed under sedation to ensure patient comfort, and the physician monitors the patient throughout the process to manage any potential complications.
After the completion of the colonoscopy and ablation procedure, the patient is typically monitored in a recovery area until the effects of sedation wear off. It is common for patients to experience some cramping or discomfort following the procedure, which usually resolves within a short period. The physician will provide specific post-procedure care instructions, which may include dietary recommendations and activity restrictions. Patients are often advised to avoid strenuous activities for a short time and to follow up with their healthcare provider for any necessary evaluations or additional treatments based on the findings from the colonoscopy. It is also important for patients to report any unusual symptoms, such as severe abdominal pain, fever, or rectal bleeding, to their healthcare provider promptly.
| Short Descr | LESION REMOVAL COLONOSCOPY | Medium Descr | COLSC FLX PROX SPLENIC FLXR ABLTJ LES | Long Descr | Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special rules for multiple endoscopic procedures apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 9 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8D - Endoscopy - colonoscopy | MUE | Not applicable/unspecified. | CCS Clinical Classification | 76 - Colonoscopy and biopsy |
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| 2015-01-01 | Deleted | Code deleted, see 45388 |
| Pre-1990 | Added | Code added. |
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