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Thread: Cpt 45385

  1. #1

    Question Cpt 45385

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    I work in a free standing ASC facility (Gastroenerology) doing Colonoscopies. Can a doctor code a 45385 and use V76.51 as the first dx and 211.3 as the second dx linked to the procedure. This claim be going out electronically on a 1500 fI am a little confused. I thought only to use the 211.3 linked to the 45385 but the doctor wants it changed. What is the correct way?



  2. #2
    Join Date
    Apr 2007
    New Port Richey & Gulf to Bay


    I would bill the diagnosis codes as V76.51 and 211.3 if the case was originally scheduled for a screening. I remember reading something from Medicare about this situation, and also the ICD-9 guidelines mention guidelines for screening as well. AdvanceWeb.com/HIM also has a great article about colonoscopy coding. Best of luck!

  3. #3


    yes check http://www.ngsmedicare.com/HomePage.aspx for your medical policy.

  4. #4
    Join Date
    Apr 2007


    Yes, you should bill it with 45385 if the polyp was removed through snare. If your MD also removed another polyp with other technique, let say excisional biopsy, you can add 45380-59. If the purpose of the procedure was for screening, your 1st dx code is V45.76 and 2ndary is 211.3. But remember in doing your form or electronic bill, you must assign the dx code 211.3 to CPT code 45385. Meaning to say, your list should go like:

    CPT DX
    45385 2
    45380-59 2

    Hope this help.

  5. #5
    Join Date
    Apr 2007
    Redding, CA


    I agree with the comments above, but you would use a V76.51, not a V45.76 as the last poster listed. I bill for an ASC gastroentorology specific as well, and I do this all the time, and haven't had any problems whatsoever. You can use the V76.51 on any of the colonoscopy codes, and list the polyp or whatnot second. This is as long as the procedure was indicated to be a screening in the beginning. In fact, the guidelines state that this is the proper way to do it.

  6. #6


    I work in an ASC also. When patients come in for a screening (v76.51) and a polyp is removed by snare, we bill all of our insurances w/ 76.51 as primary and 211.3/211.4(wherever polyp was removed)

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