Wiki Colonoscopy in outpatient setting

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umcanes4

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Hello. Wanted to get some clarification. :)

Colonoscopy- physician introduced scope through anus and advanced to the terminal ileum, with ID of the appendiceal orifice and IC Valve. The colonoscopy was performed without difficulty. The quality of the bowel preparation was fair to poor. He did cold biopsies of multiple areas. Anesthesia was given.

This is for an outpatient facility our hospital owns, so we would do 45380 with modifier 52 or 74? I am leaning towards the 74 because of the note that is listed under 52. Our boss decided to get us a different type of CPT code book and it has a note under the 45380 stating to use modifier 52.

If anyone could share your thoughts, I would appreciate it greatly!!!
 
The 74 modifier is for a facility claim whereas the 52 is for a professional claim. Are you billing for the facility or the physician?
 
I am billing for the facility on this one. The reason why I questioned if the 52 modifier was used is because this new CPT book our boss got us is not the CPT procedural book from AMA that I am used to using. So this book shows the 52 modifier can be used under the ASC even though it has a note use the 73 or 74 modifier under it. :) Sorry, long day. But thank you for replying. Glad to know the way I was leaning was the correct way. Thanks again!
 
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