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Gastroenterology Coding Alert

You Be the Coder:

Capture Technique For Multiple Polyp Removals

Published on Sun May 13, 2012

Question: Our gastroenterologist recently performed a proctosigmoidoscopy. During the procedure, he removed two polyps, one using hot biopsy forceps and another using the snare. I am of the opinion that we have to report this procedure using the code 45315 as it is a multiple polyp removal but my fellow colleague is saying that this is not correct. Please tell me whether or not this is correct? If not, then what is the right method to report this procedure?Wisconsin SubscriberAnswer: When you are trying to report polyp removal by proctosigmoidoscopy, you need to look at a number of factors. You will have to look at the number of polyps that were removed and you will also have to look at the technique(s) that your gastroenterologist used to remove the polyp(s).If your gastroenterologist removes a single polyp using cautery or hot biopsy forceps, then you should report the procedure using 45308 [...]
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