How To Use CPT Code 45350

CPT 45350 describes the procedure of sigmoidoscopy with band ligation(s) for conditions such as hemorrhoids. 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 45350?

CPT 45350 is used to describe the procedure of sigmoidoscopy with band ligation(s) for conditions such as hemorrhoids. This code is used when a healthcare provider uses a flexible sigmoidoscope to examine the rectum and sigmoid colon and performs band ligation on structures such as hemorrhoids.

2. Official Description

The official description of CPT code 45350 is: ‘Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids).’ It is important to note that CPT 45350 should not be reported in conjunction with CPT 45334 for the same lesion, and it should not be reported in conjunction with CPT 45330, 45349, or 46221. Additionally, CPT 45350 should not be reported more than once per session. To report control of active bleeding with band ligation(s), CPT 45334 should be used.

3. Procedure

1. The healthcare provider prepares the patient for the procedure, ensuring appropriate prepping and anesthesia.
2. The provider introduces a flexible sigmoidoscope into the rectum to examine the sigmoid colon.
3. Using the sigmoidoscope, the provider identifies the internal hemorrhoid(s) or other structures that require treatment.
4. The provider mobilizes the structure(s) to locate the base and then tightly ligates it with a rubber band.
5. The aim of the procedure is to stop the blood supply to the structure, causing tissue death and shedding of the structure.
6. Multiple ligations may be performed if necessary.
7. Finally, the provider removes the sigmoidoscope.

4. Qualifying circumstances

CPT 45350 is used for patients who require sigmoidoscopy with band ligation(s) for conditions such as hemorrhoids. Hemorrhoids are inflated veins in the anus that cause pressure during bowel movements. The procedure is performed by a healthcare provider who uses a flexible sigmoidoscope to examine the rectum and sigmoid colon and performs band ligation on the identified structures. It is important to note that CPT 45350 should not be reported in conjunction with CPT 45334 for the same lesion, and it should not be reported in conjunction with CPT 45330, 45349, or 46221. Additionally, CPT 45350 should not be reported more than once per session.

5. When to use CPT code 45350

CPT code 45350 should be used when a healthcare provider performs sigmoidoscopy with band ligation(s) for conditions such as hemorrhoids. It is important to follow the guidelines and not report CPT 45350 in conjunction with CPT 45334 for the same lesion, or in conjunction with CPT 45330, 45349, or 46221. Additionally, CPT 45350 should not be reported more than once per session.

6. Documentation requirements

To support a claim for CPT 45350, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for sigmoidoscopy with band ligation(s)
• Details of the procedure, including the use of a flexible sigmoidoscope and the number of ligations performed
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 45350, ensure that the procedure is performed by a qualified healthcare provider and that it meets the criteria for sigmoidoscopy with band ligation(s). It is important to follow the guidelines and not report CPT 45350 in conjunction with CPT 45334 for the same lesion, or in conjunction with CPT 45330, 45349, or 46221. Additionally, CPT 45350 should not be reported more than once per session.

8. Historical information

CPT 45350 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 band ligation for a patient with hemorrhoids.
2. A colorectal surgeon using a flexible sigmoidoscope to perform band ligation on internal hemorrhoids.
3. A proctologist performing sigmoidoscopy with band ligation(s) for a patient with rectal bleeding.
4. An interventional radiologist performing band ligation on structures during a sigmoidoscopy procedure.
5. A general surgeon using a flexible sigmoidoscope to perform band ligation on internal hemorrhoids in an outpatient setting.
6. A gastroenterologist performing sigmoidoscopy with band ligation(s) for a patient with recurrent hemorrhoids.
7. A colorectal surgeon performing band ligation on structures during a sigmoidoscopy procedure for a patient with anal pain.
8. An interventional radiologist using a flexible sigmoidoscope to perform band ligation on internal hemorrhoids in a hospital setting.
9. A proctologist performing sigmoidoscopy with band ligation(s) for a patient with chronic constipation.
10. A general surgeon performing band ligation on structures during a sigmoidoscopy procedure for a patient with anal itching.