Wiki Modifer for poor colonoscopy prep

[slimmagnum]

GOOD AFTERNOON,
I'M CONFUSED! OUR DOCTOR PERFORMED A COLONOSCOPY (#45380) WITH POOR PREP, THEN PERFORMED ANOTHER SUCCESSFUL COLONOSCOPY (#45384) ON SAME PATIENT A MONTH LATER. I NEED TO BILL THEM WITH APPROPRIATE MODIFIER(S) TO MEDICARE. DO I USE A 52 OR 53 MODIFIER ON POOR PREP PROCEDURE AND DO I NEED A MODIFIER ON SUCCESSFUL PROCEDURE. THANKS IN ADVANCE FOR YOUR HELP

 

[mitchellde]

You need a modifier on the first one, 52 if it was completed pass the splenic flexure. Different opinions if it is before that point.
#1 if it past the rectum but prior to the scenic flexure code it as a sigmoidoscopy
#2 if it is not past the rectum code it with the 53
#3 use the 53 regardless of how far it went.
You should not need a modifier for the second one.
Also on the first one you need V64.1 dx code as a secondary dx code.

 

[cfassett001]

This made me giggle! Love how spellcheck changed splenic to scenic. Gives a colonoscopy a whole new twist!

 

[mitchellde]

I hate it when that happens! But I think I will leave it, just sounds better.