polyp removal colonoscopy

[Erin.Foley]

If you have two polyps removed during a colonoscopy with different techniques my understanding is that you would bill for both. For example if one polyp was removed by snare technique and the other by hot biopsy technique both the 45385 and 45384 would be reported at the same encounter because they are separate lesions by two different techniques. Does the second CPT code require a 59 modifier? Is anyone experience insurance companies bundling them into one CPT code?

 

[CodingKing]

Modifier 59 yes.

Some payers have their own policy they only pay for the highest RVU code regardless of number of polyps, location or methods.

 

[syllingk]

They have to be in separate locations. Descending, Transverse, etc. Otherwise you bill the highest code that was done for that location. You could use a -59 or a -XS.