Wiki Coding of Colonoscopies


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When coding colonoscopies that result in more than one polyp removal with more than one mode of removal what is the correct coding? I have been taught and from what I can find in publications and the medicare site you would use the appropriate code for the removal and code the highest level as your primary procedure (exa: 45384), then code 45380-59. Is there ever a situation where you would use both modes of removal and use a modifier 22 on the highest level code of 45384 and not code the second mode of removal? Help!:confused:
The problem with using the modifier 22 and not coding for the second removal is that you are saying that the provider's difficulty was that primary removal, and you aren't truly coding for the secong polyp removal at all. You should really code with the modifier 59 on this one since the removals are in two different sites, and that qualifies for 59.
thanks so much for your input. We have a clinic here that insists on coding in this fashion and I know that is incorrect but just wanted to hear it from another source. I really appreciate your input! Thanks! :)