Gastroenterology Coding Alert

Question: My gastroenterologist performs mapping biopsies on patients who have inflammatory bowel disease. In this procedure, the doctor performs an endoscopy and takes a biopsy every 20 centimeters or so. How should I code this? California Subscriber Answer: No matter how many biopsies your physician takes, code CPT 45380 (Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple) once. If the procedure is unusually extensive or time consuming, you could append modifier 22 (Increased procedural services). You would have to provide the payer with a well-documented and convincing argument -- comparison of time with a normal biopsy procedure, number of biopsies and sites, substantial complications -- as to why it should give your office additional reimbursement. Even then, you shouldn't hold your breath in anticipation of extra money.