Part B Insider (Multispecialty) Coding Alert

Reader Question:

Find Out Whether You Can Report 57800 and 57454 Together

Question: Our doctor specifies that the cervical canal has to be dilated (57800) in order to complete colposcopy procedure (57454). Can both these codes be billed together for payment?

Answer: No, they cannot. The Correct Coding Initiative (CCI) permanently bundles 57800 (Dilation of cervical canal, instrumental [separate procedure]) into 57454 (Colposcopy of the cervix including upper/adjacent vagina; with biopsy[s] of the cervix and endocervical curettage). 

Your only option is to add modifier 22 (Increased procedural services) to 57454 — but only if your physician’s documentation supports significant additional work in doing the dilation. He should also include the time it took over and above the usual procedure time.

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