How To Use CPT Code 45190

CPT 45190 describes the destruction of a rectal tumor using various methods such as electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery through a transanal approach. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 45190?

CPT 45190 can be used to describe the destruction of a rectal tumor using a transanal approach. The provider may choose from a variety of methods such as electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery to perform this procedure. It is important to note that this code specifically refers to the destruction of the tumor, not its excision.

2. Official Description

The official description of CPT code 45190 is: ‘Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. A digital rectal exam is performed to assess the tumor and verify its location.
3. An anoscopy procedure may also be performed to further examine the anus and rectum.
4. Using a transanal approach, the provider destroys the rectal tumor using one of the available methods: electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery.

4. Qualifying circumstances

CPT 45190 is used when a rectal tumor needs to be destroyed using a transanal approach. The patient must have a tumor in the rectum, and the provider must choose one of the specified methods (electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery) to perform the destruction. It is important to note that this code does not cover the excision of the tumor or the use of other approaches.

5. When to use CPT code 45190

CPT code 45190 should be used when a provider needs to destroy a rectal tumor using a transanal approach. It is important to ensure that the destruction is performed using one of the specified methods (electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery). If the tumor is excised or a different approach is used, a different CPT code should be selected.

6. Documentation requirements

To support a claim for CPT code 45190, the provider must document the following information:

• Patient’s diagnosis and the presence of a rectal tumor
• Method used for the destruction (electrodesiccation, electrosurgery, laser ablation, laser resection, or cryosurgery)
• Date of the procedure
• Details of the procedure, including any additional procedures performed (such as anoscopy)
• Any complications or adverse events
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 45190, ensure that the destruction of the rectal tumor is performed using a transanal approach. Use the appropriate CPT code if the tumor is excised or a different approach is used. It is important to follow the specific guidelines provided by the payer and include all necessary documentation to support the claim.

8. Historical information

CPT code 45190 was added to the Current Procedural Terminology system on January 1, 1995. There have been several changes to the code over the years, including updates to the description and the addition of specific methods for the destruction of the rectal tumor.

9. Examples

1. A provider using electrodesiccation to destroy a rectal tumor through a transanal approach.
2. A provider performing laser ablation to destroy a rectal tumor using a transanal approach.
3. A provider utilizing cryosurgery to destroy a rectal tumor through a transanal approach.
4. A provider using electrosurgery to destroy a rectal tumor using a transanal approach.
5. A provider performing laser resection to destroy a rectal tumor through a transanal approach.
6. A provider using electrodesiccation to destroy a rectal tumor through a transanal approach.
7. A provider performing laser ablation to destroy a rectal tumor using a transanal approach.
8. A provider utilizing cryosurgery to destroy a rectal tumor through a transanal approach.
9. A provider using electrosurgery to destroy a rectal tumor using a transanal approach.
10. A provider performing laser resection to destroy a rectal tumor through a transanal approach.