AHA Coding Clinic® for HCPCS - 2023 Issue 3; Ask the Editor

Polypectomy of colon by hybrid ESD and EMR technique

A patient presented for excision of an adenomatous colon polyp by a hybrid endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) technique. Gel was injected with adequate lift of the lesion from the muscularis propria. A circumferential incision was made around the lesion into the submucosa with a hybrid ESD knife. The periphery of the lesion was marked with the tip of the ESD knife with cautery followed by full circumferential incision. The lesion was then partially dissected (hybrid ESD) from the underlying deep layers with electrocautery. A snare was then placed around the lesion and snare cautery excision was performed. Some submucosal fibrosis was noted requiring the polyp to be excised partially en block and partially with piecemeal snare excision. The polyp was retrieved and the hybrid ESD resection defect was closed. May both CPT code 45390 and HCPCS code C9779 be reported when performed on the same polyp? How is this polypectomy by hybrid ESD/EMR reported? ...

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