Wiki colonoscopy/EGD-control bleed

[stacyprice]

This colonoscopy is done for iron deficiency anemia. The provider placed the hemostatic clip to prevent bleeding post-intervention. There was no bleeding at the end of the procedure. My question is if the patient is not already bleeding (colonoscopy or EGD) but the clip was placed to prevent bleeding (not to stop it) can 45382 be charged during colonoscopy and 43255 for EGD. The clip is not being placed as a marker. The provider is doing this after the removal of a polyp so the site does not bleed.

 

[thomas7331]

You should not report a procedure done to control bleeding if it was done as a result of another procedure that was performed, so it would not be appropriate to code this in the case you describe here. Per CPT instructions, if the "bleeding occurs as a result of an endoscopic procedure, control of bleeding is not reported separately during the same operative session." This has also been clarified in CPT Assistant, September 1996: "The codes are intended to be used when treatment is required to control bleeding that occurs spontaneously, or as a result of traumatic injury (noniatrogenic), and not as the result of another operative intervention."

 

[stacyprice]

thank you and I also have a patient that a full colonoscopy (down to the cecum) but the patient is to return because of poor visualization due to prep. Since it was a full colonoscopy should a modifier be used?

 

[lcolborn]

A full colon and met the cecum, however poor visualization and will bring patient back...., in this case, what I would do is append a modifier 52 so that we can get a full reimbursement on the repeat procedure.