How To Use CPT Code 45337

CPT 45337 describes the procedure of sigmoidoscopy with decompression for pathologic distention, such as volvulus or megacolon. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 45337?

CPT 45337 can be used to describe the procedure of sigmoidoscopy with decompression for pathologic distention, specifically for conditions like volvulus or megacolon. This code is used when a healthcare provider examines the rectum and sigmoid colon using a sigmoidoscope, a flexible tube with a camera, and performs decompression if necessary.

2. Official Description

The official description of CPT code 45337 is: ‘Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed.’ It is important to note that CPT code 45337 should not be reported in conjunction with CPT code 45330, and it should not be reported more than once per session.

3. Procedure

1. The healthcare provider begins by appropriately prepping and anesthetizing the patient.
2. Using a sigmoidoscope, a flexible tube with a camera, the provider inserts it through the anus and advances it into the anal canal, rectum, and sigmoid colon.
3. The provider carefully examines the colon for any signs of volvulus or megacolon, which may present as abnormally dilated or widened areas distal to the obstruction.
4. If a volvulus or megacolon is identified, the provider may introduce a stiff tube through the channel in the sigmoidoscope to decompress the intestine.
5. This decompression helps straighten the twisted loop and relieve the distended intestine.
6. Once the procedure is complete, the provider withdraws the sigmoidoscope, and in some cases, may leave the decompression tube in place for several days to ensure complete decompression of the colon.

4. Qualifying circumstances

CPT 45337 is performed when a patient presents with pathologic distention, such as volvulus or megacolon, requiring decompression. The procedure is typically performed by a healthcare provider who is experienced in sigmoidoscopy. It is important to note that CPT code 45337 should not be reported in conjunction with CPT code 45330, and it should not be reported more than once per session.

5. When to use CPT code 45337

CPT code 45337 should be used when a sigmoidoscopy procedure is performed with decompression for pathologic distention, specifically for conditions like volvulus or megacolon. It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code.

6. Documentation requirements

To support a claim for CPT code 45337, the healthcare provider must document the following information:

• Patient’s diagnosis indicating the need for sigmoidoscopy with decompression
• Details of the procedure performed, including the use of a sigmoidoscope and any decompression techniques
• Date and duration of the procedure
• Any additional relevant findings or interventions during the procedure
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 45337, ensure that the procedure meets the specific criteria outlined in the official description. It is important to note that CPT code 45337 should not be reported in conjunction with CPT code 45330. Additionally, the code should not be reported more than once per session. It is recommended to review the specific billing guidelines provided by the payer to ensure accurate and appropriate reimbursement.

8. Historical information

CPT code 45337 was added to the Current Procedural Terminology system on January 1, 1990. The code underwent a change on January 1, 2015, with the description being updated to ‘Sigmoidoscopy, flexible; with decompression of volvulus, any method.’

9. Examples

1. A healthcare provider performs sigmoidoscopy with decompression for a patient with a volvulus, using a sigmoidoscope and introducing a decompression tube.
2. During a sigmoidoscopy procedure, a healthcare provider identifies a megacolon and performs decompression using a stiff tube.
3. A patient presents with pathologic distention, and a healthcare provider performs sigmoidoscopy with decompression to relieve the condition.
4. Using a sigmoidoscope, a healthcare provider performs sigmoidoscopy with decompression for a patient with a suspected volvulus, confirming the diagnosis and providing immediate relief.
5. During a sigmoidoscopy procedure, a healthcare provider identifies a megacolon and successfully decompresses it using a decompression tube.
6. A patient with a history of volvulus undergoes sigmoidoscopy with decompression to prevent recurrence and alleviate symptoms.
7. Using a sigmoidoscope, a healthcare provider performs sigmoidoscopy with decompression for a patient with suspected megacolon, confirming the diagnosis and providing immediate relief.
8. During a sigmoidoscopy procedure, a healthcare provider identifies a volvulus and performs decompression using a stiff tube, effectively resolving the obstruction.
9. A patient with a known megacolon undergoes sigmoidoscopy with decompression to manage symptoms and improve overall bowel function.