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General Surgery Coding Alert

You Be the Coder:

Control of Bleeding With Surgical Procedures

Published on Thu Jan 01, 2004

Question: When can we report the control of bleeding separately, such as during colonoscopy?

Florida Subscriber

Answer: Here's a rule of thumb when trying to determine whether you can separately report your surgeon's measures to control bleeding: If the procedure causes the bleeding, then managing the bleeding is included in the procedure fee.
 
For example, the surgeon must inject epinephrine to control bleeding that starts during a polyp removal by snare technique. The control of bleeding is included in the code for the tumor removal, 45385 (Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique).
 
According to Principles of CPT Coding, the codes for endoscopic control of bleeding by any method "are intended to be used when treatment is required to control bleeding that occurs spontaneously, or as a result of traumatic injury (noniatrogenic), and not as a result of another type of operative intervention."
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