Part B Insider (Multispecialty) Coding Alert

Question: What is the appropriate CPT® code for a colonoscopy when documentation states "White light and narrow band imaging modes were used to examine the entire colon." No biopsies or other procedures performed with the colonoscopy.

Answer: The standard colonoscopy techniques makes use of a white light and narrow band imaging uses a blue light to view the areas of the colon. The blue light used in narrow band imaging is believed to improve the contrast that is supposed to aid in the identification of intestinal polyps more efficiently.

While some gastroenterologists prefer the use of narrow band imaging owing to the claimed ability to better detect polyps, studies have shown that not much difference exists between the two techniques in enabling the better identification of polyps. Regardless of what technique your gastroenterologist prefers in performing a colonoscopy, you should remember that there are no separate CPT® codes for standard white light colonoscopy and narrow band imaging colonoscopy. In the scenario that you have described, as there were no biopsies performed, you can opt to report 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[(s] by brushing or washing, with or without colon decompression [separate procedure]) as your gastroenterologist only viewed the colon without performing any other procedures.