Wiki Fecal Microbiota Transplant - from stool bank

[lovelyadd]

If your provider is receiving the matter from a stool bank, how are you billing for this? Per the stool bank website, you should not be billing g0455 nor 44705. For Medicare patients, if the medical necessity for a 45378 colonoscopy is not met, all they did was install the FMT, are you billing the unlisted code or g0455 with 52 modifier? If the medically necessity is met for 45378 are you billing just that or also additional charges for the instillation (unlisted or G0455,52)? Thanks

 

[01065679]

I have been billing the 44705 with a 52 modifier but have trouble with G0455 with a 52 modifier. I am currently researching to see if that is allowed but I remember reading that it is an all or nothing deal. I used to use the unspecified code but wouldnt get paid even with an appeal with documentation.