Colonoscopy with polyp removal and biopsies

[askmmbg@gmail.com]

If you have one polyp removed during a colonoscopy by snare technique and separate multiple biopsies of aphthpous ulcerations performed, can you bill for both 45385 and 45380. My understanding is the 45380 bundles into the 45385 per CCI but the doctor insists on billing both separate. Anyone have thoughts?

 

[afalcon@dhcla.com]

45385 for the polyp and 45380-59/-XS for the ulceration. These codes can be billed together.

 

[askmmbg@gmail.com]

But I thought if they are both in the same area (transverse colon), they were inclusive according to CCI?

 

[SienTC1720]

As far as I have always known, and have only been doing surgical coding for a few years, you can only use -59 on colonoscopies if it is in a separate area. Whether transverse/right/left etc. it has to be done in separate areas to qualify as separate procedures.

 

[askmmbg@gmail.com]

okay thank you