Wiki Colonoscopy with polyps removed & Lost

[JanRebecca]

How do I code the colon polyps (ICD 10) if the op note says two were removed and the location BUT they were lost - so there is no pathology on them??!!

 

[andrel.jones@nyumc.org]

IN MY OPINION, YOU SHOULD BILL COLONOSCOPY WITH REMOVAL OF POLYP AS THE PROVIDER DID PERFORM SERVICE. THE FACT THE SPECIMEN WAS LOST WOULD NOT AFFECT THE PHYSICIAN BILLING BUT WOULD AFFECT PATHOLOGY BILLING.

Andrel Jones, CCS-P, CPC, CPC-I
abccodingservices@gmail.com

 

[JanRebecca]

But what would be the ICD 10 to use? since we don't know what kind of polyp?

 

[mitchellde]

I would just code as colon polyp, there is a code for this just go to the index and look up polyp then colon.

 

[dkissel]

You should be able to code specifically (ascending, descending, sigmoid etc) from the op note.

 

[tammygiessregen]

We billed Medicare for 45385-59 modifier for the endoscopy, 45380 for colonoscopy and 43239-51 for EGD. All paid except 45380. Has anyone been paid for all 3 codes together as the biopsies where taken in different areas of the colon. Any help is appreciated. TIA

 

[dkissel]

We billed Medicare for 45385-59 modifier for the endoscopy, 45380 for colonoscopy and 43239-51 for EGD. All paid except 45380. Has anyone been paid for all 3 codes together as the biopsies where taken in different areas of the colon. Any help is appreciated. TIA

When billing colonoscopies, only the highest level (in your case, the 45385) is billable. The 45380 is inclusive.

 

[Vivy48]

We billed Medicare for 45385-59 modifier for the endoscopy, 45380 for colonoscopy and 43239-51 for EGD. All paid except 45380. Has anyone been paid for all 3 codes together as the biopsies where taken in different areas of the colon. Any help is appreciated. TIA

We billed Medicare for 45385-59 modifier for the endoscopy, 45380 for colonoscopy and 43239-51 for EGD. All paid except 45380. Has anyone been paid for all 3 codes together as the biopsies where taken in different areas of the colon. Any help is appreciated. TIA

The 59 modifier needs to go on 45380 as long as this was a different polyp,then you should be paid for all. They are not inclusive