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Incomplete Colonoscopy-In the CPT

  1. #1
    Unhappy Incomplete Colonoscopy-In the CPT
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    In the CPT it states a colonoscopy that is incomplete, after full prep for a colonoscopy is done, is billed with a 52 modifier. If the doctor does not go past the splenic does this mean it should be billed as a flex sig 45330 or as a 45378 - 52?

  2. #2
    If a colonoscopy is planned and the exam is incomplete because the scope does not pass beyond the splenic flexure, I would bill the colonoscopy with modifier even though RVUs are the same as sigmoidoscopy. Note, though, that Medicare requires a -53 modifier for incomplete colonoscopy. For other payers, -52 modifier is more appropriate by definition.
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3
    thank you!

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