If, for example, a physician performs biopsy of the cecum using cold forceps and then does a SPOT injection in the cecum for tattooing, the physician CANNOT bill 45380, 45381 -59 can they? There is no CCI edit for these two codes, but I my understanding of modifier 59 was that it indicates a separate site, but if both procedures were performed in the same site, only the biopsy would be billed correct? Or actually, considering that there is no CCI edits for this, I guess both procedures would be billed without modifier 59??? I don't know, I'm not all that familiar with endoscopic GI procedures and I'm getting confused. HELP!