How To Use CPT Code 45347

CPT 45347 describes the procedure of sigmoidoscopy with the placement of an endoscopic stent. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 45347?

CPT 45347 can be used to describe the procedure in which a healthcare provider examines the rectum and sigmoid colon using a sigmoidoscope. During this procedure, the provider also performs the endoscopic introduction of a stent. It is important to note that CPT 45347 should not be reported in conjunction with CPT codes 45330 and 45340. If fluoroscopic guidance is performed during the procedure, CPT code 74360 should be used.

2. Official Description

The official description of CPT code 45347 is: ‘Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed).’ It is important to remember the notes associated with this code, such as not reporting it with CPT codes 45330 and 45340, and using CPT code 74360 for fluoroscopic guidance.

3. Procedure

1. When performing CPT 45347, the healthcare provider ensures that the patient is appropriately prepped and anesthetized.
2. The provider then inserts a sigmoidoscope through the anus to examine the rectum and sigmoid colon for any obstruction or stricture.
3. If an obstruction or stricture is identified, the provider places the scope at the site to determine the length of the stent needed.
4. To assist with introducing the stent, the provider may introduce a guide wire and perform dilation of the site if necessary.
5. Using the endoscopic approach, the provider places a stent at the site of obstruction to remove the stricture.
6. Dilation may be performed before or after stent placement, or both, depending on the severity of the obstruction.
7. Once the stent is placed and any necessary dilation is completed, the provider removes the sigmoidoscope.

4. Qualifying circumstances

CPT 45347 is performed on patients who have an obstruction or stricture in the rectum or sigmoid colon that requires the placement of an endoscopic stent. The procedure is typically performed by a healthcare provider who is trained in sigmoidoscopy and stent placement. It is important to note that CPT 45347 should not be reported in conjunction with CPT codes 45330 and 45340.

5. When to use CPT code 45347

CPT code 45347 should be used when a healthcare provider performs sigmoidoscopy with the placement of an endoscopic stent. It is important to ensure that the procedure meets the specific criteria outlined in the official description of the code. Additionally, CPT 45347 should not be reported in conjunction with CPT codes 45330 and 45340.

6. Documentation requirements

To support a claim for CPT 45347, the healthcare provider must document the following information:

• Indication for the procedure, such as the presence of an obstruction or stricture
• Details of the pre- and post-dilation, if performed
• Use of a guide wire, if applicable
• Length of the stent placed
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 45347, it is important to ensure that the procedure meets the specific criteria outlined in the official description of the code. CPT 45347 should not be reported in conjunction with CPT codes 45330 and 45340. If fluoroscopic guidance is performed during the procedure, CPT code 74360 should be used. It is important to review the specific billing guidelines provided by insurance payers to ensure accurate and appropriate reimbursement.

8. Historical information

CPT 45347 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition.

9. Examples

1. A gastroenterologist performing sigmoidoscopy with the placement of an endoscopic stent to relieve an obstruction in a patient with sigmoid colon cancer.
2. A colorectal surgeon performing sigmoidoscopy with the placement of an endoscopic stent to treat a patient with a benign stricture in the rectum.
3. An interventional radiologist performing sigmoidoscopy with the placement of an endoscopic stent to alleviate an obstruction caused by diverticulitis in a patient.
4. A general surgeon performing sigmoidoscopy with the placement of an endoscopic stent to manage an obstruction in a patient with inflammatory bowel disease.
5. An oncologist performing sigmoidoscopy with the placement of an endoscopic stent to relieve an obstruction in a patient with metastatic rectal cancer.
6. A gastroenterologist performing sigmoidoscopy with the placement of an endoscopic stent to treat a patient with a recurrent stricture in the sigmoid colon.
7. A colorectal surgeon performing sigmoidoscopy with the placement of an endoscopic stent to manage an obstruction in a patient with radiation proctitis.
8. An interventional radiologist performing sigmoidoscopy with the placement of an endoscopic stent to alleviate an obstruction caused by a rectal foreign body in a patient.