Flex sig decompression same day as colonoscopy

[cboston]

A doctor performs a colonoscopy with polyp removal. Later the same day the patient has abdominal distention and pain. Can the doctor bill for the return to the endoscopy suite to perform a flex sig decompression? We billed a 45385 and 45330-78. The insurance denied as bundled. Is this the same rule as when you cause the bleed you can not bill for the control of bleed or not? Please help I have never encounter this problem before.
Thank you

[pamsbill]

Here is what I would do:

Write an appeal letter to the insurer explaining it was a completely separate procedure and completely separate trip to the endosuite. Attach the report for the flex to support your claim. Send it off and let them decide if they feel it is separately reimbursable. If they deny your appeal then you have your answer.

It is only going to ever pay at 50% of the flex rate so you are not fighting for thousands of dollars, but it is worth a letter.

PM

[cboston]

Thank you PM. I'll give it a try.