# polypectomy vs. biopsy



## anknight77 (Dec 5, 2011)

There was a 3mm sessile polyp noted in the proximal ascending colon as well as a 5mm sessile polyp noted in the mid ascending colon, both of which were removed with cold pinch polypectomy.  There was a 7-8 mm pedunculated polyp in the sigmoid which was removed with hot snare polypectomy.  I would say this would be 45385 but would like some clarification...Thanks!


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## ajs (Dec 5, 2011)

anknight77 said:


> There was a 3mm sessile polyp noted in the proximal ascending colon as well as a 5mm sessile polyp noted in the mid ascending colon, both of which were removed with cold pinch polypectomy.  There was a 7-8 mm pedunculated polyp in the sigmoid which was removed with hot snare polypectomy.  I would say this would be 45385 but would like some clarification...Thanks!



Well the procedure description fits the code so it looks good to me.


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## scorrado (Dec 6, 2011)

I have never heard of "cold pinch" but when I see cold it makes me think 45380.  Something you might want to look at.


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## coachlang3 (Dec 6, 2011)

I agree with Scorrado here.

Polypectomy just means removal of a polyp really not the "how" it was removed.  "Pinch" is the key word here.  Does the doctor mean snared (45385)?  cold biopsied (45380)? hot biopsied (45384)?  Could be any of them.

You need to clarify with the doctor what he/she means by pinched.


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## eescalante (Dec 28, 2011)

The 45385 is correct for the hot snare removal in the sigmoid colon. I agree with the other responders that you need clarification of what "cold pinch" means before coding that polyp removal in the ascending colon. If it is also a snare - then bill only the 45385. If it was another method, then since this is a different area of the colon, add that code with the 59 or 51 modifier depending on your payer. 

For instance:

45385
45380 -59


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