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Colonoscopy? Or Flex-Sig?

D

debrooth

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Doctor inserts videoscope via rectum and visualizes the 1 foot long colon, all the way to the terminal ileum. (Patient had much of colon removed due to cancer.) There are no anatomical landmarks, i.e. the splenic flexure, in the colon that we typically use to help us determine if a colonoscopy was "complete". But, he did visualize the patient's entire colon -- as short as it is -- and made it to the terminal ileum. My doctor feels guilty billing a colonoscopy, 45378, and thinks perhaps he should bill a Flex-Sig, 45330.
I would appreciate some opinions here, friends! :o
 
Guilt cannot come into coding. The doctor did a complete colonsocopy and should bill as such.

I do not have on hand any documentation, but if the doctor went all the way, doesn't matter the length, then he went all the way.
 
52 modifier

When you "plan" to perform a reduced procedure the appropriate modifier is -52. The patient is missing much of the colon, therefore the physician knows in advance that the colonoscopy procedure will be reduced.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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