• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Polypectomies

R

RCBBuell

Contributor
Messages
18
Location
Post Falls, ID
Help,

When you are doing colonoscopy and you do more than one kind of polypectomy such as CPT 45384 and 45385 do you just use mod 59 or do you do the combo 51, 59. In the office we are having a difference of opinion.
Most of the information I can dig up is just showing -59.


Thanks for your help.

Becky:confused:
 
We use a 59 only, it depends on the insurance whether they will pay or not for second procedure. We have one in particular that will NOT pay for a second, no matter the reasoning.
 
Mainly, we just use 59. The exception is Wellcare who requires us to use 51 and 59 (crazy). There are a few companies who will not pay both no matter what. Soemthimes, we appeal with op note and get pay. Also, a good idea is to use different ICD-9 codes when you can. For example, if hot forceps removal in ascending colon and snare in rectosigmoid, then we may use 211.3 for hot forceps and 211.4 for rectosigmoid. We use the op and path to bill b/c shows location and status of benign/malignant.
 
You must log in or register to reply here.
Top