1. T

    Wiki Modifier PT with 53

    Hello! I am newer to billing for Gastroenterology and I need some help! :) Patient was seen for a colon screen- few small mouthed diverticula were found in sigmoid colon also large amount of stool causing DR to abort. Claim was originally billed as 45380 PT 53. Medicare denied for invalid...
  2. D

    Wiki Same mass multiple techniques used Colonoscopy

    Hello I need help, I know if you code a colonoscopy and multiple techniques are used to remove DIFFERENT masses/polyps you code each technique and add mod 59 to the others of less value. BUT my question is what if its the SAME mass and they used 2 techniques to remove the same mass. Can you...
  3. lamiller

    Wiki CPT 45385 and 45380 Together

    I am getting tons of denials from BCBS Medicare Advantage in Tennessee with 45385 and 45380 billed together. I have use 59 and XS modifiers and still denied. The denial code is C045 and some C0131. Does anybody have any thoughts on this??? Thanks for the help in advance.
  4. lamiller

    Wiki CPT 45385 and 45380 billed together

    I am having a lot of denials from Blue Cross Medicare Advantage in Tennessee when billing 45385 and 45380 together. I have tried several different modifiers on 45380 including, 59, XS. XU and 59/51. The denial comes back stating claim specific negotiated discount. Anybody have any ideas?
  5. L

    Wiki Colonoscopy - Biopsy, then fulguration

    I have a DR who does a lot of colonoscopy's. I have been coding them for about 6 months, but am now training another individual, so I am second guessing a couple things. All help would be appreciated. Dr states: "In the mid rectum, she had 3-4 small polyps the I cold biopsy x2 and then...
  6. U

    Wiki Colonoscopy in outpatient setting

    Hello. Wanted to get some clarification. :) Colonoscopy- physician introduced scope through anus and advanced to the terminal ileum, with ID of the appendiceal orifice and IC Valve. The colonoscopy was performed without difficulty. The quality of the bowel preparation was fair to poor. He did...