I have been told since learning endoscopy coding to reduce the fees for the 2nd, 3rd, etc. procedure that may have been done following the scope rules. So for example, provider did a 45380 and 45385. We would bill that as 45385 (full fee) and 45380-59 (fee of 45378 subtracted from 45380). I don't see anything on CMS.gov that states you have to reduce the fee before submitting the claim, just that they would process the claim payment based on those rules.
Does anyone else reduce their fees when billing EGDs or colonoscopies? If they don't, do you have any references that could be helpful in showing why you shouldn't do this?
Thanks!
Does anyone else reduce their fees when billing EGDs or colonoscopies? If they don't, do you have any references that could be helpful in showing why you shouldn't do this?
Thanks!