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!