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Gastroenterology Coding Alert

Reader Question:

Don't Sweat Over Discontinued Colonoscopy Procedure

Published on Thu Apr 05, 2012

Question: Our gastroenterologist performed a diagnostic colonoscopy but was unable to get past the rectum due to a tight surgical colorectal anastomosis. Our gastroenterologist suggested that the patient would need surgery to correct the anastomosis. He also mentioned inadequate preparation for the procedure and discontinued the procedure. He then sent the patient to radiology for a barium enema examination. Can I bill the colonoscopy procedure that our gastroenterologist attempted? If so, should I use the modifier 52 or 53? Oklahoma Subscriber Answer: Since your gastroenterologist started out with the procedure, you can bill the colonoscopy with 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]). However, since the procedure was discontinued due to an unexpected situation (colorectal anastomosis), you will have to append the modifier 53 (Discontinued procedure) to the colonoscopy code. The modifier [...]
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