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  #1  
Old 08-25-2009, 12:25 PM
southbaymed southbaymed is offline
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Default 45385/45383 vs 45380

I understand 45385/45383/45384 includes biopsy.
However, sometime Dr. suggests to bill 45383 & 45380-59
I think he did extensive work for biopsy. Could anyone
give me any idea in what situtation we can bill biopsy -59?
I feel some coding book(?) or AMA(?) suggesting to physicians to bill both code w/59
Thank you
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Old 08-25-2009, 02:35 PM
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pygreen pygreen is offline
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CPT 45380 can be billed separately IF the biopsy is done on a separate polyp or part of the colon. It can also be used when a different polyp is removed by cold biopsy. Example, Polyp removed in the cecum by hot bx (45384) another polyp in the transverse colon is removed by cold biopsy (45380-59). Modifier 59 indicates that one procedure was performed separately and independently from the other.
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Old 08-25-2009, 02:42 PM
mad_one80 mad_one80 is offline
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I AGREE WITH PEGGY.

You can use the -59 modifier as long as the doctor documents that different approaches were done. He can have a snare, cold biopsy and heater probe done at the same time as well BUT you can only bill one approach per surgery, like if he did a cold biopsy on one polyp and a biopsy on another polyp you CANT bill 45380 and 45380-59....hope this article helps.

http://health-information.advanceweb...pectomies.aspx
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Old 08-25-2009, 07:49 PM
southbaymed southbaymed is offline
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thank you for clear explanations. Now with confidence
I can use these codes.
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