Wiki multiple polyps

[KoBee]

Can someone help better understand when we can unbundle polyps. can I still give credit for hemo clip since it was a different polyp in different site?

example: 3 polyp removal

1st polyp, 4mm located in cecum, removed by cold snare = 45385
2nd polyp, 10 mm located in ascending, removed by hot snare = 45385
3rd polyp, 4mm located in ascending, removed by cold snare, hemostatis was achieved with placement of one hemoclip.= 45385, 45382 ( but 45382is bundled )

45385
45382 - 59

 

[such78]

what is postoperative diagnoses for bleeding control? Should not code control bleeding when it is for surgical site bleeding achieved, it is a part of procedure.

 

[lcolborn]

Can someone help better understand when we can unbundle polyps. can I still give credit for hemo clip since it was a different polyp in different site?

example: 3 polyp removal

1st polyp, 4mm located in cecum, removed by cold snare = 45385
2nd polyp, 10 mm located in ascending, removed by hot snare = 45385
3rd polyp, 4mm located in ascending, removed by cold snare, hemostatis was achieved with placement of one hemoclip.= 45385, 45382 ( but 45382is bundled )

45385
45382 - 59

Control of bleeding cannot be billed in this case( clipping the polyp , it bled, you caused the bleed, you stop it) . It is inclusive.
And since they are both taken from the same area of the colon( ascending) you bill for the code with the higher RVU only, not per style of the removal
per say or the number of polyps taken. Now this being said, if the provider however had to deal with multiple polyps than normal, he can state the
extra work provided and may be billed with a 22 modifier( just saying) . Hope this helps.