Answer: Let's use the example of colonoscopies to explain the use of laser ablation. The corresponding colonoscopy code is 45383 (Colonoscopy; with ablation of tumor[s], polyp[s], or other lesion[s] not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique). You may have overlooked this code because it seems at first glance to be a hodge-podge code for all methods of removing a polyp that are not by snare technique or hot biopsy forceps. Since the term "ablation" simply means "to remove or excise," most gastroenterol-ogists use the term to refer to the use of argon plasma coagulators (APC), lasers, heater probes or other devices to cauterize a lesion, angiodysplasia, polyp, or the remnants of a polyp to the point that it is destroyed.
Gastroenterologists often use the ablation code in this manner for a follow-up colonoscopy. If the polyp removed during the initial colonoscopy was benign, the physician may perform a follow-up colonoscopy a few months later. This is necessary because when the physician uses snare to remove the initial polyp, there are some cells still present that must be removed at a later date since so much burning and removal was done during the initial visit.
Treating the site with APC, which uses argon gas to deliver thermal energy to a field of tissue adjacent to the probe, is one of the more popular methods for destroying the leftover cells. Cauterization done with APC, laser or heater probe should be reported with the ablation code (45383). However, not all follow-up visits to remove the remainder of the polyp will include ablation. If snare technique is used, you should report 45385.
The use of these cauteries is not limited to ablation only. All of these methods mentioned (APC, laser, heater probe) can also be used to control bleeding.
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