Results 1 to 5 of 5

colonoscopy - The physician removes a polyp

  1. Default colonoscopy - The physician removes a polyp
    Medical Coding Books
    The physician removes a polyp from the transverse colon, then a smaller polyp at the rectum during a screening. Are both polyps coded or just one? the physician has charged for both on his pro fee and is adamant about this.

  2. #2
    Location
    Columbus, Ohio
    Posts
    77
    Default
    Was the removal techniques the same for both removals?

  3. Default
    If the doctor used the same technique on both polyps he can not bill for them separately.

    if he used a snare for the transverse and a cold bx for the rectal then he can bill for them using modifier 59 on the bx removal.

  4. #4
    Default
    If the physician removes the polyps via different methodologies, (i.e. snare, hot biopsy forceps, or cold biopsy forceps) and the polyp is in a different region of the colon, then yes absolutely!! Please see below:

    45380: colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple
    1. The physician performs the colonoscopy and obtains tissue samples
    2. This code can be reported ONCE regardless of the number of biopsies taken
    3. According to CPT assistant, July 2004, this code is also to be used to describe polypectomy with cold biopsy forceps
    4. If the physician does remove a polyp or other lesion with a different technique and then takes a biopsy of a separate lesion this code may be reported in addition with the appendage of -59 modifier.

    Hope this helps!
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  5. #5
    Location
    Columbus, Ohio
    Posts
    77
    Thumbs up
    I concur with jamierenay different techniques = additional reporting with -59. Which is what I was attempting to find out.
    Amy I don't believe the polyp needs to be in a different region of the colon as log as the two separate techniques are used they are each individually reportable.

Similar Threads

  1. Screening Colonoscopy versus Surveillance Colonoscopy
    By wsoler in forum Gastroenterology
    Replies: 20
    Last Post: 06-16-2017, 11:41 AM
  2. Colonoscopy -actual procedure if Dr performs
    By BSCOTT@GIHEALTHCARE.COM in forum AAPC Coding Challenge
    Replies: 4
    Last Post: 05-06-2015, 02:56 PM
  3. Screening Colonoscopy vs Problem Colonoscopy
    By puggles in forum General Surgery
    Replies: 5
    Last Post: 03-25-2014, 05:08 AM
  4. colonoscopy
    By ddebbied in forum Modifiers
    Replies: 3
    Last Post: 04-02-2009, 11:03 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.