OCTOber 2016

Endoscopic Mucosal Resection (EMR)

The following information comes from the gastroenterology CPT advisers representing the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA) and the American Society for Gastrointestinal Endoscopy (ASGE) working in conjunction with the AMA who has also published this information in CPT Assistant Dec. 2014.

The purpose of an EMR is to lift the lesion to create space between the lesion and submucosal tissue and “use of a specialized device to isolate the tissue that is going to be removed”.

There are three components to this type of procedure.

  1. Submucosal injection to lift the lesion
  2. Demarcation of the lesion, often by creating a pseudopolyp of tissue
  3. Endoscopic snare resection

If all three components of the EMR are not performed then 45390 should not be reported, but rather the actual services performed which in most instances is only the saline lift injection (45381) and snare polypectomy (45385).


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