flexible sigmoidoscopy cpt code

Flexible Sigmoidoscopy CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Examples

Flexible sigmoidoscopy CPT code(s) 45330-45350 bills for service when the physician performs flexible sigmoidoscopy to explore the lower part of the colon with the help of scope. A sigmoidoscope incorporates via the rectum to examine the lower part of the colon.

Flexible Sigmoidoscopy CPT Code Description 

A scope consists of a tiny camera at the tip of the tube that aids in examining the rectum internally. The physician may obtain samples for biopsy.

The following are the reasons why the physician performs flexible sigmoidoscopy:

To screen for colon cancer if age is older than 50 or at average risk of colon cancer.

To detect polyps or ulcers

Abdominal cramping

Irregular bowel movements

Rectal bleeding

Chronic diarrhea

Other intestinal disorders

Flexible Sigmoidoscopy CPT Code 45330

Flexible Sigmoidoscopy CPT code 45330 bills for service when the physician performs flexible, diagnostic sigmoidoscopy, including the specimens collection by brushing or washing.

sigmoidoscopy flexible cpt code

Flexible Sigmoidoscopy CPT Code 45331

CPT 45331 bills for service when the physician performs flexible sigmoidoscopy and single or multiple biopsies.

cpt code for flexible sigmoidoscopy

Flexible Sigmoidoscopy CPT Code 45332

CPT 45332 bills for service when the physician performs flexible sigmoidoscopy with foreign body removal.

flexible sigmoidoscopy with andre tall manometry studies cpt code

CPT 45333

CPT 45333 bills for service when the physician performs flexible sigmoidoscopy with the removal of tumor(s), polyp(s), or other lesions (s) by hot biopsy forceps

cpt code for flexible sigmoidoscopy with argon plasma coagulation

CPT 45334

Flexible Sigmoidoscopy CPT code 45334 bills for service when the physician performs flexible sigmoidoscopy with control of bleeding, any method

CPT 45334

CPT 45335

CPT 45335 bills for service when the physician performs flexible sigmoidoscopy with control of bleeding, any method.

CPT 45335

CPT 45337

CPT 45337 bills for service when the physician performs flexible sigmoidoscopy with decompression for pathologic distention such as volvulus and megacolon, including placement of decompression tube.

CPT 45337

CPT 45338

CPT 45338 bills for service when the physician performs flexible sigmoidoscopy with the removal of tumor(s), polyp(s), or other lesions (s) by snare technique

CPT 45338

CPT 45346

Flexible Sigmoidoscopy CPT code 45346 bills for service when the physician performs flexible sigmoidoscopy with ablation of tumor(s), polyp(s), or other lesions (s) (including pre-and post-dilation and guide wire passage

CPT 45346

CPT 45340

CPT 45340 bills for service when the physician performs flexible sigmoidoscopy with transendoscopic balloon dilation

CPT 45340

CPT 45341

CPT 45341 bills for service when the physician performs flexible sigmoidoscopy with endoscopic ultrasound examination

CPT 45341

CPT 45342

CPT 45342 bills for service when the physician performs flexible sigmoidoscopy with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)

CPT 45342

CPT 45347

Flexible Sigmoidoscopy CPT code 45347 bills for service when the physician performs flexible sigmoidoscopy with the placement of an endoscopic stent (includes pre-and post-dilation and guide wire passage

sigmoidoscopy

CPT 45349

CPT 45349 bills for service when the physician performs flexible sigmoidoscopy with endoscopic mucosal resection

flexible sigmoidoscopy

CPT 45350

CPT 45350 bills for service when the physician performs flexible sigmoidoscopy with endoscopic mucosal resection

cpt code for flexible sigmoidoscopy with apc

Flexible Sigmoidoscopy CPT Code Reimbursement

A maximum of one unit can be a bill on the same service date of Flexible Sigmoidoscopy CPT code(s) 45330-45350. In contrast, the three units allow documentation supporting the service’s medical necessity.   

The cost and RUVS of CPT 45330 are $61.40 and 1.77434 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45330 are $225.27 and 6.50959 when performed in the non-facility.

The cost and RUVS of CPT 45331 are $78.24 and 2.26081 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45331 are $352.71 and 10.19206 when performed in the non-facility.

The cost and RUVS of CPT 45332 are $114.18 and 3.29934 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45332 are $334.57 and 9.66784 when performed in the non-facility.

The cost and RUVS of CPT 45333 are $101.83 and 2.94244 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45333 are $403.54 and 11.66094 when completed non-facility.

The cost and RUVS of CPT 45334 are $127.76 and 3.69186 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45334 are $612.86 and 17.70961 when performed in the non-facility.

The cost and RUVS of CPT 45335 are $72.17 and 2.08551 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45335 are $359.65 and 10.39276 when performed in the non-facility.

The cost and RUVS of CPT 45337 are $123.78 and 3.57680 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45337 are $123.78 and 3.57680 when performed in the non-facility.

The cost and RUVS of CPT 45338 are $130.51 and 3.77115 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45338 are $360.25 and 10.40990 when performed in the non-facility.

The cost and RUVS of CPT 45346 are $173.58 and 5.01594 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45346 are $2943.90 and 85.06869 when enacted in the non-facility.

The cost and RUVS of Flexible Sigmoidoscopy CPT code 45340 are $85.02 and 2.45676 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45340 are $573.78 and 16.58026 when performed in the non-facility.

The cost and RUVS of CPT 45341 are $134.82 and 3.89569 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45341 are $134.82 and 3.89569 when performed in the non-facility.

The cost and RUVS of CPT 45342 are $183.81 and 5.31160 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45342 are $183.81 and 5.31160 when performed in the non-facility.

The cost and RUVS of CPT 45347 are $166.95 and 4.82423 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45347 are $166.95 and 4.82423 when performed in the non-facility.

The cost and RUVS of Flexible Sigmoidoscopy CPT code 45349 are $214.58 and 6.20076 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45349 are $214.58 and 6.20076 when performed in the non-facility.

The cost and RUVS of CPT 45350 are $109.53 and 3.16511 when performed in the facility. In contrast, the reimbursement and RUVS of CPT 45350 are $845.11 and 24.42086 when performed in the non-facility.

Flexible Sigmoidoscopy CPT Code Modifiers

The following are the list modifiers applicable with Flexible Sigmoidoscopy CPT code(s) 45330-45350 :  

22, 23, 47, 51, 52, 53, 54, 55, 56, 58, 59, 62, 63, 76, 77, 78, 79, 80, 81 82, 99, , AS, CC, CR, ET, EY, GA, GC, GK, GR, GU, GY, GZ, KX, Q5, Q6, QJ, SG, TC, XR, XP, XU, XS, AI, AQ, AR.  

Modifier 47 is applicable CPT 45330-45350 when the surgeon administers general or regional anesthesia to the patient. It is not appropriate to report modifier 47 with anesthesia procedures. 

Modifier 76 is appropriate with CPT 45330-45350 when a similar service performs by the Same Physician on the same service date.  

Modifier 54 is applicable with CPT 45330-45350 when the physician provides surgical care only. In contrast, Modifiers 55 and 56 attach to CPT 45330-45350 when the physician performs post-management and preoperative care only.  

Modifier 76 is applicable with Flexible Sigmoidoscopy CPT code(s) 45330-45350 when a similar service performs by a different Physician on the same service date.  

Modifier 59 is applicable with CPT 45330-45350 when a Distinct service performs by the physician and bundled with another procedure on the same date.    

Modifier X {E, P, S, U} is applicable instead of Modifier 59 with CPT 45330-45350 when service bills to Medicare insurance. It divides the modifier into four parts for further specification of the procedure.  

Modifier 53 will be reported with CPT 45330-45350 if an unsuccessful attempt for a flexible sigmoidoscopy makes due to unavoidable circumstances like allergic reactions to the substance.  

Modifier 22 applies to CPT 45330-45350 when services perform longer than usual and take extra resources during the procedure.  

Modifier 23 is applicable with CPT 45330-45350 when general or local anesthesia administers by the physician and routinely does not require during the procedure.    

Modifier 52 applies when the physician does not complete the sigmoidoscopy service and terminates due to unavoidable circumstances.  

If physicians believe that Medicare will deny such service, reporting with a GA modifier is appropriate. The beneficiary must sign an Advance Beneficiary Notification (ABN), and CPT 45330-45350 must apply the GA modifier to that service.

Flexible Sigmoidoscopy CPT Code Billing Guidelines

Documentation should support the medical necessity of service. It reflects that service is medically necessary and appropriate.  

Flexible Sigmoidoscopy CPT code(s) 45330-45350 includes control bleeding due to endoscopic procedure during the same operative session, entire rectum, entire sigmoid colon, and portion of descending colon when performed.

If CT colonography (74261-74263) bills in addition to CPT 45330-45350, it is appropriate to report CPT codes 74261-74263 separately.

It is appropriate to report examination colon through stoma when performed with Colonoscopy (44388-44408, 44401) and CPT 45330-45350.

It is appropriate to report an examination colon through stoma when performed with Ileoscopy (44380-44384, 44381) and CPT 45330-45350.

Medicare may not accept the CPT code when sigmoidoscopy performs for screening purposes, and it is an appropriate report with G0104.

Flexible Sigmoidoscopy CPT Code Examples

Description:

Sigmoidoscopy performs for evaluation of anemia and gastrointestinal bleeding.

PROCEDURE: Sigmoidoscopy.

INDICATIONS: gastrointestinal bleeding and anemia.

MEDICATIONS: Fentanyl (Sublazine) 0.2 mg IV Versed (midazolam) 2 mg IV

BIOPSIES: No BRUSHINGS

PROCEDURE: The patient takes to the operating room. The physician obtains the surgical consent and operative site and verifies patient identification. The physician administered anesthesia to the patient and shaved, prepped, and then sterilely prepped and draped. 

The physician places the patient in the left lateral decubitus position, the sigmoidoscope incorporated into the rectum, and, under direct visualization, advanced to 20 cm. 

The prep quality was good, and the patient endured the procedure well. There were no complications.

FINDINGS: Was unable to pass scope beyond 20 cm because of stricture vs. very short bends secondary to multiple previous surgeries. Other than the results noted above, the visualized colonic segments were standard. External hemorrhoids found.

IMPRESSION: Internal hemorrhoids External hemorrhoids Unable to pass scope beyond 25 cm due to stricture or very sharp bend secondary to multiple surgeries. Unsuccessful Sigmoidoscopy. Otherwise, Normal Sigmoidoscopy to 25 cm. External hemorrhoids found.

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