Wiki Endoscopies-I would love


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I would love some feed back from fellow coders about how others bill for endoscopies. I did not receive any response from the Gastroenterology thread.

How would you code the following:

EGD w/ Biopsy
Colonoscopy w/ hot forcep biopsy and snare polypectomy ?

I have been instructed many ways, the most recent answer states that you would bill both the hot biopsy 45354 with a 59 and the 45385, as well as the 43249 with a 59 showing that each one was a seperate site. However, carriers obviously do not like this.

Any help or recommendations appreciated very much.

You should bill 45385 with no modifier (it has the highest RVU's).
Bill 45384 with modifier 59 as long as it was at a different section of the colon than the snare--otherwise it is bundled.
Bill 43239 for EGD w/ bx. You don't need a modifier with this since it is a different body part.
The payment for 45384 is very small but you do get something.