Wiki colonoscopy & polypectomy coding

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coding4fun

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Can anyone shed some light on correct billing for colonoscopy & polypectomy with snare & bicapping billing. I am billing combo 45385, 45380 & 45378 and getting denials (anthem). Medicare is not paying 45382 & 45380 combo. Any comments or assistance would be greatly appreciated.
 
First of all, you should never code a diagnositc or base colonoscopy 45378 with a therapeutic colonoscopy 45379-45392. This goes for all scope procedures. Second, 45382 bundles into 45380 per NCCI edits. 45382 is intended to be used when treatment is required to control bleeding that occurs spontaneously or as a result of traumatic injury, not as the result of another operative intervention. For example, control of bleeding due to polypectomy is not separately coded for. If you are reporting 45382 in the intended manner you will need to append modifier -59 to show it is unrelated to other colonscopy codes you may be billing. Many of the colonoscopy codes bundle so you should check the edits before billing.
 
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