tci General Surgery Coding Alert - 2001 Issue 7

Reader Question: Modifier -59 With Multiple Colonoscopies

Question: When coding a colonoscopy with snare polypectomy at the cecum and biopsy at the sigmoid, should I use 45385 and CPT 45380 -51-59?  Utah Subscriber   Answer: Most carriers no longer require modifier -51 (multiple procedures) because they can determine multiple procedures without it. For multiple endoscopies from the same family (in this case, colonoscopies), modifier -51 should never be used, says Susan Callaway, CPC, CCS-P, an independent coding and reimbursement specialist and educator in North Augusta, S.C. Instead, the procedure should be billed using the multiple-endoscopy rule. The highest valued procedure (in this case 45385...

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