tci General Surgery Coding Alert - 2019 Issue Q3

Reader Question: Include India Ink in Surgery

Question: During a colonoscopy, the surgeon used a snare to remove two polyps from different sites, marking them by injecting India ink to identify their location for the pathology exam. Can we bill separately for the inking? SuperCoder Subscriber Answer: Most payers consider inking included in the more comprehensive service of removing the colonic polyps, which you should report as 45385 (Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique). Medicare does not reimburse specifically for inking, and you won’t find any specific CPT® code for the procedure. Stand alone: If the surgeon injects...

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