Help - out for chromoscopy

[charlottedavis]

Please help! Does anyone know how to bill out for chromoscopy. Please look at the following dictation attached. Any suggestions on how to properly code this dictation ? Thank you in advance for any advice.

A 15mm polyp was found in the proximal ascending colon. The polyp was Paris classification is (protruding sessile). Preparations were made for mucosal resection. Chromoscopy with methylene blue was done to mark the borders of the lesions. 5 mL of saline with methylene blue was injected to raise the lesion.
Snare mucosal resection with suction (via the working channel) retrieval was performed. A 20 mm area was resected. Three pieces were resected in total. Resection and retrieval were complete. There was no bleeding during, and at the end, of the procedure. Area was tatooed with an injection of 2mL of spot carbon black. Tatooed delivered just proximal to the polypectomy site.

Two benign appearing Paris classification polyps we found in the rectum and in the sigmoid colon. The polyps were 8 to 10 mm size. These polyps were removed with a hot snare. Resection and retrieval were complete.

 

[syllingk]

is that the whole note? I can't tell for sure with just this portion but take a look at 45390

 

[charlottedavis]

Chromoscopy with methylene blue

I agree with you on that code 45390 but how would you code for the Chromoscopy with methylene blue was done to mark the borders of the lesions?

Thank you

 

[pamsbill]

I would bill a 45381-59 with the 45390. I am sure you will have to appeal it but you have the grounds. The 45381 saline injection is included in the 45390 but the 45381 ink injection is separately billable. I have had some appeals denied, but I have had more paid than denied.