CPC Study Guide 2026

When different polypectomy techniques are used during the same colonoscopy, the higher-valued procedure (45338, snare) is listed first and the additional technique (45333, hot biopsy forceps) uses modifier -59 to indicate a distinct procedural service.

G codes are temporary codes used by CMS to identify professional healthcare procedures and services that are under review or do not have a CPT code. They are often used for new or emerging technologies and services. J codes are for drugs, L codes are for orthotics/prosthetics, and E codes are for durable medical equipment.

CPT 44150 represents a total abdominal colectomy without proctectomy with ileostomy or ileoproctostomy, while 44155 includes proctectomy.

This is the core distinction between the two primary coding systems. ICD (International Classification of Diseases) codes describe the patient's medical condition or diagnosis, explaining *why* a service was performed. CPT (Current Procedural Terminology) codes, on the other hand, describe the specific medical, surgical, and diagnostic services or procedures *what* was done to treat the patient. Both are essential for complete and accurate medical billing.

CPT 45338 specifically describes sigmoidoscopy with removal of tumor(s) or polyp(s) by snare technique, distinguishing it from 45333 which uses hot biopsy forceps.

Upcoding is a fraudulent billing practice where a healthcare provider assigns a CPT or ICD-10-CM code that represents a more complex or expensive service than what was actually performed or documented. This practice leads to inflated reimbursement from payers, including federal programs like Medicare and Medicaid. Upcoding is a serious compliance violation and can result in significant penalties under the False Claims Act.