General Surgery Coding Alert

Question: One of our surgeons recently asked if we can charge separately for brushes used during diagnostic colonoscopies. Is there a supply code we can use for this?


New York Subscriber

Answer: CPT does include miscellaneous supply code 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies or materials provided]), and you can also find various supply codes in HCPCS - but chances are that you won't be able to bill extra for brushes supplied during diagnostic scopes.

Medicare payers include the cost of brushes in the standard reimbursement for diagnostic scopes, and even the CPT descriptor for 99070 specifies for supplies and materials "over and above" those usually needed to provide the service. The brushes necessary for a diagnostic scope, in contrast, are a standard part of every endoscopy service.

The same goes for endoscopic biopsy forceps, snares, balloons, needles, etc. All of these supplies are included in the facility reimbursement if the physician performs the procedures at a facility - or in the site-of-service differential if the physician performs the procedures in the office.

For private payers, you may be able to specify separate payment for brushes as part of your contract, but if you negotiate a fair fee for the test itself, such a step shouldn't be necessary.