Summary & Overview
CPT 45382: Colonoscopy with Endoscopic Control of Colonic Bleeding
CPT code 45382 designates a colonoscopic procedure performed to identify and control sources of lower gastrointestinal bleeding. It combines diagnostic visualization of the colon and rectum using a colonoscope with therapeutic interventions to achieve hemostasis. Nationally, this code is important because gastrointestinal bleeding is a common acute presentation that often requires timely endoscopic management to reduce morbidity, avoid transfusion, and shorten hospital stays.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for the code, typical sites where the service is delivered (ambulatory surgical centers and hospital endoscopy suites), and what to expect in payer coverage discussions. The publication also summarizes common billing considerations, typical modifiers used with endoscopic therapeutic procedures, and related claims-processing and documentation themes.
The content provides benchmarks and policy-relevant updates useful for coding professionals, revenue cycle teams, and clinical leaders: when CPT code 45382 applies, how it aligns with procedural intent (diagnosis plus hemostasis), and the practical settings in which the service is performed. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 45382 describes a diagnostic and therapeutic colonoscopy performed with a colonoscope to identify sources of internal bleeding in the colon and rectum and to control that bleeding using endoscopic methods. This procedure involves direct visualization of the colon and rectum via a tubular instrument with a light source and camera and includes therapeutic maneuvers to achieve hemostasis.
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Service type: Endoscopic diagnostic and therapeutic procedure
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Typical site of service: Ambulatory surgical center or hospital endoscopy suite
Clinical & Coding Specifications
Clinical Context
A 64-year-old male presents to the emergency department with bright red rectal bleeding and symptomatic anemia (lightheadedness, tachycardia). Emergency department staff obtain basic labs and resuscitate with IV fluids and blood products as indicated. After hemodynamic stabilization, the gastroenterology team performs an urgent colonoscopy with a colonoscope to locate the bleeding source and provide endoscopic hemostasis. The procedure occurs in an endoscopy suite or hospital operating room under monitored anesthesia care or general anesthesia. During the colonoscopy the endoscopist inspects the entire colon and rectum, identifies an actively bleeding diverticulum in the ascending colon, and achieves hemostasis using endoscopic clipping and/or thermal coagulation. Post-procedure the patient is observed in a recovery area, receives serial exams and hemoglobin monitoring, and is either admitted for observation or discharged with follow-up depending on clinical stability.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the colonoscopic hemostasis required substantially greater effort or complexity than usual and documentation supports increased work. |
25 |