General Surgery Coding Alert

Question: During a colonoscopy, the surgeon used a snare to remove two polyps from different sites, marking them by injecting India ink to identify their location for the pathology exam. Can we bill separately for the inking?

Codify Subscriber

Answer: Most payers consider inking included in the more comprehensive service of removing the colonic polyps, which you should report as 45385 (Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique).

Medicare does not reimburse specifically for inking, and you won’t find any specific CPT^® code for the procedure.

Stand alone: If the surgeon injects India ink during a colonoscopy to mark something for later evaluation, you may be able to report that stand-alone procedure using 45381 (Colonoscopy, flexible; with directed submucosal injection(s), any substance).