AHA Coding Clinic® for HCPCS - 2019 Issue 3; For Your Information

Transanal minimally invasive surgery (TAMIS)

A transanal rectal excision with a transanal minimally invasive surgery (TAMIS) platform was performed on a patient with a posterior rectal adenoma. Electrocautery was used to begin the dissection taking the mucosa down to the sphincter muscle and advancing left to right to remove the lesion from the left posterior part of the sphincter muscle. Once the anal ring was passed the TAMIS platform was set up. The remainder of the resection was completed with the TAMIS platform using electrocautery on scissors. What is the correct code assignment for a TAMIS transanal excision? We have been advised to assign CPT code 0184T, but the code descriptor specifies transanal endoscopic microsurgery (TEMS). It is not clear if a TAMIS is the same as a TEMS or if CPT codes 45171 or 45172 should be assigned instead. ...

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