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Code deleted, see 45346

Official Description

Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A flexible sigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the sigmoid colon using a flexible endoscope. This procedure is specifically designed for the ablation of tumors, polyps, or other lesions that cannot be removed using traditional methods such as hot biopsy forceps, bipolar cautery, or snare techniques. During the procedure, a standard flexible sigmoidoscope is inserted into the anus and advanced through the rectum into the sigmoid colon. Air insufflation is utilized to expand the colon and separate the mucosal folds, allowing for a clear view of the internal structures. Once the scope is in place, it is withdrawn to inspect the mucosa carefully. If any tumors, polyps, or lesions are identified, they can be treated accordingly. In cases where lesions are amenable to removal, a snare technique may be employed, as described in CPT® Code 45338. However, for lesions that require ablation, CPT® Code 45339 is utilized, which involves the use of alternative techniques such as laser ablation. In this method, a laser device is introduced through the endoscope and directed at the lesion, starting from the proximal margin and moving along the entire lesion to effectively destroy it.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for the following conditions:

  • Tumors Presence of tumors in the sigmoid colon that require ablation rather than removal.
  • Polyps Identification of polyps that are not suitable for removal by standard techniques.
  • Lesions Other lesions in the sigmoid colon that cannot be excised using hot biopsy forceps, bipolar cautery, or snare techniques.

2. Procedure

The procedure involves several key steps to ensure effective examination and treatment of the sigmoid colon.

  • Step 1: Preparation The patient is positioned appropriately, and the area is prepared for the procedure. This may include ensuring the bowel is adequately cleansed prior to the sigmoidoscopy.
  • Step 2: Insertion of the Sigmoidoscope A flexible sigmoidoscope is gently inserted into the anus and advanced through the rectum into the sigmoid colon. Care is taken to navigate the anatomy without causing discomfort.
  • Step 3: Air Insufflation Air is insufflated through the sigmoidoscope to expand the colon, which helps to separate the mucosal folds and provides a clearer view of the internal structures.
  • Step 4: Inspection of the Mucosa The sigmoidoscope is withdrawn slowly, allowing for a thorough inspection of the mucosal surface for any abnormalities such as tumors, polyps, or lesions.
  • Step 5: Ablation of Lesions If a lesion is identified that is not amenable to removal by snare technique, the ablation process begins. A laser device is introduced through the endoscope and positioned at the proximal margin of the lesion. The ablation is performed by moving the laser device along the lesion as the endoscope is retracted, effectively destroying the lesion.

3. Post-Procedure

After the procedure, the patient may be monitored for any immediate complications or adverse reactions. It is important to provide post-procedure care instructions, which may include dietary recommendations and activity restrictions. Patients should be informed about potential symptoms to watch for, such as bleeding or severe abdominal pain, and advised to contact their healthcare provider if these occur. Follow-up appointments may be scheduled to assess recovery and discuss any further treatment options if necessary.

Short Descr SIGMOIDOSCOPY W/ABLATE TUMR
Medium Descr SIGMOIDOSCOPY FLX ABLTJ LESION
Long Descr Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 3 - Special rules for multiple endoscopic procedures apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code 45330  Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P8C - Endoscopy - sigmoidoscopy
MUE Not applicable/unspecified.
CCS Clinical Classification 77 - Proctoscopy and anorectal biopsy
Date
Action
Notes
2015-01-01 Deleted Code deleted, see 45346
1994-01-01 Added First appearance in code book in 1994.
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