tci General Surgery Coding Alert - 2005 Issue 11

READER QUESTIONS: Expect Reduced Payment for Multiple Endoscopes

Question: How can I report colonoscopy with snare polypectomy at the cecum and biopsy at the sigmoid?Michigan Subscriber Answer: You should report 45385 (Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique) for the polypectomy and 45380 (... with biopsy, single or multiple) for the biopsy.And you should append modifier 59 (Distinct procedural service) to 45380 to differentiate it from 45385 at a separate location. If you leave off the 59, the payer will bundle the procedures.Although you may report both 45385 and 45380 in this case, the...

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