CPT® Code 45390

A flexible colonoscopy with endoscopic mucosal resection (EMR) is a minimally invasive procedure that allows for the examination and treatment of lesions within the colon. During this procedure, a standard flexible colonoscope, which is a long, flexible tube equipped with a camera and light source, is inserted into the rectum and carefully advanced through the entire length of the colon, reaching the cecum or the terminal ileum. The use of air insufflation is critical as it helps to inflate the colon, separating the mucosal folds and enhancing visibility for the physician. This thorough examination enables the identification of any mucosal lesions present. Once a lesion is located, its borders are precisely marked using electrocautery, a technique that employs electrical current to create a controlled burn, ensuring clear delineation of the area to be treated. To facilitate the removal of the lesion, diluted adrenaline is injected into the submucosal layer surrounding the lesion. This injection serves to lift the mucosal layer, creating a space that separates the lesion from the underlying muscle tissue. Following this preparation, a snare with a suction cup is utilized to further detach the mucosal lesion from the surrounding tissue. The lesion is then excised and captured using the snare, after which the colonoscope is carefully withdrawn, completing the procedure. This technique is particularly effective for removing certain types of polyps and other abnormal growths, allowing for both diagnostic and therapeutic interventions during a single procedure.