Wiki 45385/45383 vs 45380

[southbaymed]

I understand 45385/45383/45384 includes biopsy.
However, sometime Dr. suggests to bill 45383 & 45380-59
I think he did extensive work for biopsy. Could anyone
give me any idea in what situtation we can bill biopsy -59?
I feel some coding book(?) or AMA(?) suggesting to physicians to bill both code w/59
Thank you

 

[pygreen]

CPT 45380 can be billed separately IF the biopsy is done on a separate polyp or part of the colon. It can also be used when a different polyp is removed by cold biopsy. Example, Polyp removed in the cecum by hot bx (45384) another polyp in the transverse colon is removed by cold biopsy (45380-59). Modifier 59 indicates that one procedure was performed separately and independently from the other.

 

[mad_one80]

I AGREE WITH PEGGY.

You can use the -59 modifier as long as the doctor documents that different approaches were done. He can have a snare, cold biopsy and heater probe done at the same time as well BUT you can only bill one approach per surgery, like if he did a cold biopsy on one polyp and a biopsy on another polyp you CANT bill 45380 and 45380-59....hope this article helps.

http://health-information.advanceweb.com/Article/Coding-Colonoscopies-Polypectomies.aspx

 

[southbaymed]

thank you for clear explanations. Now with confidence
I can use these codes.