The term "ablation" more commonly describes an erosive or corrosive removal, such as laser, cryotherapy, or chemotherapy. If the surgeon describes polyp ablation by any of those methods, 45383 would clearly be the best choice.
POLYP ABLATION USING SNARE TIP
Let’s start by looking at some information that’s contained in the following op note;
In the right colon, two 6 to 7mm polyps were noted. Using snare polypectomy technique with cautery both of these polyps were removed. The colonoscope was then withdrawn into the rectum where a small, flat 1 or 2mm polyp was found and this time the polyp was ablated using cautery from the tip of the polypectomy snare.
The question is, should a coder report 45383 (ablation) in addition to 45385 (snare) for the rectal polyp that was ablated?
No, not according to the AMA which refers to information from the American Society for Gastrointestinal Endoscopy (ASGE). Ablation of small polyp(s) is not often performed as a stand-alone procedure, but commonly will occur when using a snare to remove much larger polyps. When it’s not necessary to submit a tissue specimen and the same tool is used to expedite removal the physician work involved does not warrant reporting an additional CPT code. There is also the argument that this type of polyp would be amenable to removal by other techniques (biopsy forceps, hot biopsy, or bipolar cautery) so for the example listed above the only service that should be reported is 45385 – Colonoscopy with removal of tumor(s), polyps(s), or other lesion(s) by snare technique.