# Colonoscopy with Polyp Removal



## tfrick2 (Aug 11, 2012)

I can't decide how best to code this colonoscopy:

Multiple diverticula were found in the sigmoid colon. A large flat polyp 
     was found in the cecum. The polyp was ~20 mm in size and had poorly 
     defined margins. There was a focal area of fibrosis at the margin of the 
     polyp, likely related to previous biopsy. The submucosa below the polyp 
     was injected with saline mixed with indigo carmine for a lift 
     polypectomy. The polyp was removed with a piecemeal technique using a 
     hot snare. Polyp resection was incomplete, due to inability to ensnare a 
     very flat portion of the polyp. Numerous attempts were made, using 
     several different types of snares. The resected tissue was retrieved. 
     Coagulation for destruction of remaining portion of lesion using argon 
     plasma was performed. 

I know 45381, 45383, & 45385 are all used for removal of this polyp, but I don't think I can code for all of them on a single polyp. Any suggestions would be greatly appreciated!

Thanks,

Tracy F, CPC, CPC-H


----------



## syllingk (Aug 13, 2012)

45385


----------



## MoonSad137 (Aug 13, 2012)

I would code 45385.


----------



## tfrick2 (Aug 13, 2012)

Thank you all for your comments. It looks like 45385 is the winner! I appreciate your help!


----------



## pamsbill (Aug 13, 2012)

Um... 45383 is worth more.  Why would you not use that and not the 45385?


----------



## nabernhardt (Aug 13, 2012)

in addition can also do the 45381 for the injection


----------

