Wiki Removing multiple polyps, multiple techniques

[tspangler72]

Hello, I have an MD that wants to bill for each polyp removed. Any advice on how to bill for the below scenario?

A. TWO -- 4 mm polyps in the cecum; sessile morphology; cold snare polypectomy performed, polyps retrieved.
B. TWO -- 2 mm polyps in the cecum; sessile morphology; cold forceps polypectomy performed, polyps retrieved.
C. 5 mm polyp in the sigmoid colon; sessile morphology; cold snare polypectomy performed, polyp retrieved.
D. 2 mm polyp in the sigmoid colon; sessile morphology; cold forceps polypectomy performed, polyp retrieved.


Thanks

 

[nsteinhauser]

Hello, I have an MD that wants to bill for each polyp removed. Any advice on how to bill for the below scenario?

A. TWO -- 4 mm polyps in the cecum; sessile morphology; cold snare polypectomy performed, polyps retrieved.
B. TWO -- 2 mm polyps in the cecum; sessile morphology; cold forceps polypectomy performed, polyps retrieved.
C. 5 mm polyp in the sigmoid colon; sessile morphology; cold snare polypectomy performed, polyp retrieved.
D. 2 mm polyp in the sigmoid colon; sessile morphology; cold forceps polypectomy performed, polyp retrieved.


Thanks

You code by instumentation used, but not per polyp. In this case:
45385
45380 - (-59 if commercial, -XS if Medicare)

If the colonoscopy started as a screening, add -33 modifiers for commercial and -PT modifiers for Medicare.
You can't code the same instrument twice in the same surgical session. So if the doctor removes 5 different polyps from 5 different locations but uses a snare to remove all of them, you would only code a single 45385.
Hope this helps.

 

[jessirussell2003]

You code by instumentation used, but not per polyp. In this case:
45385
45380 - (-59 if commercial, -XS if Medicare)

If the colonoscopy started as a screening, add -33 modifiers for commercial and -PT modifiers for Medicare.
You can't code the same instrument twice in the same surgical session. So if the doctor removes 5 different polyps from 5 different locations but uses a snare to remove all of them, you would only code a single 45385.
Hope this helps.

I agree with Nsteinhauser! very nicely stated. Jessica