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Gastroenterology Coding Alert

Reader Question:

Bill Subsequent Incomplete Colonoscopy Using Appropriate Modifiers

Published on Tue Oct 09, 2012

Question: Our gastroenterologist performed incomplete colonoscopy on a patient for three days in a row. Are these procedures billable and if so, what codes and modifiers should I use? Minnesota Subscriber Answer: In order to bill for a colonoscopy, the scope should be extended beyond the splenic flexure of the colon. If your gastroenterologist is not able to extend the scope to that distance and was able to examine the sigmoid colon and a part of the descending colon, you should report the colonoscopy using a modifier. Another instance when you will need to use the modifier to the colonoscopy code will include when the patient has a longer gastrointestinal tract than usual and your gastroenterologist is not able to extend the scope beyond the splenic flexure due to this. You will also need a modifier if your gastroenterologist is not able to advance the scope beyond the splenic flexure [...]
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