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Sig with banding

  1. #1
    Default Sig with banding
    Medical Coding Books
    Need some help. Dr. wants to do a hemorrhoid banding 46221 with a Sigmoid, same visit. Our Coding companion book shows 46221 and CCI edit 45330. 45331 is not listed. Will we get paid if he does a Sig with biopsy and banding 46221 since it doesn't show as an edit? Is claim payable if he just does sig w/ no bx and banding?

  2. #2
    We are in Ohio and found that most insurance carriers do not cover a Flex Sig or a Colonoscopy when the reason for the procedure is just to band the hemorrhoid. However if there was something else that happened with the procedure such as a biopsy or a polyp removal we have been billing those with a 59 modifier and have been getting payment along with the hemorrhoid banding.

    Hope that helps. Thanks, Robin

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