Egd/colonoscopy

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My Dr. did an EGD/colonoscopy. He removed 3 polyps. One with hot snare, then the other 2 with cold biopsy forceps. Would this code set be correct: 43235, 45385, 45384 with a -59 modifier put on it?

I would appreciate any feedback on this..

TD, CPC-A
 

coachlang3

True Blue
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Charlotte, NC
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Depends on where they saw the polyps.

The 45385 would indeed be the correct first code. If your doc did a biopsy of a polyp in another anatomical site of the colon then it would be 45380 for the biopsy with a 59 mod on it (not 45384 since you stated it was a cold biopsy). But if it was a cold biopsy of a polyp in the same anatomical site, then you don't get anything other than the original hot snare (45385).

And then of course the 43235 for the EGD.
 
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Pensacola, Florida
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I agree with Coachlang. 45385 for the snare; 45380-59 for the biopsy removal of the other polyps. 45380 is bundled into 45385, but since they are different sites, you can bill for both with the -59 modifier. And, 43235 for the EGD.
 
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