Gastroenterology Coding Alert

Question: When can we report the control of bleeding code separately from the colonoscopy? Florida Subscriber Answer: Here's a rule of thumb when trying to determine whether you can separately report your gastroeterologist's measures to control bleeding: If the procedure causes the bleeding, then managing the bleeding is included in the procedure fee. For example, a gastroenterologist has to inject epinephrine to control bleeding that starts during a polyp removal by snare technique. The control of bleeding is considered included in the code for the tumor removal, 45385 (Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique). According to Principles of CPT Coding, the codes for endoscopic control of bleeding by any method "are intended to be used when treatment is required to control bleeding that occurs spontaneously, or as a result of traumatic injury (noniatrogenic), and not as a result of another type of operative intervention."