Rigid sigmoidoscopy

CPT 45320 is the billing code for "Rigid sigmoidoscopy". For rigid sigmoidoscopy to evaluate rectum and distal sigmoid colon

Medicare pays approximately $213.81 for CPT 45320 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 45320 has a total RVU of 3.32, broken down as: Work RVU 1.20, Practice Expense RVU 2.00, and Malpractice RVU 0.12. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 45320 include: Indication for sigmoidoscopy; Extent of examination; Findings in rectum; Any abnormalities noted. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 45320: Includes rigid sigmoidoscopy. Limited examination Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 45320 include: 52 (Reduced services if procedure not completed), 53 (Discontinued procedure due to patient condition), 59 (Distinct procedural service if performed with other procedures). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 45320 is 5-10 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.