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What gets a Modifier???????

  1. #1
    Default What gets a Modifier???????
    Medical Coding Books
    I am billing for a colonscopy with snare (45385), and colonoscopy with submucosal injection (45381) and a colonoscopy with biopsy (45380). I was putting 59 mod on the snare and biopsy and leaving the injection w/o Modifier. Is that correct? Will I get reimbursed the most with that?

  2. #2
    So, just to help clarify a little bit more, when the guidelines say that they have to be separate sites in order to bill them, what that means is that if you have say a snare biopsy in the Ascending colon, and a biopsy in the transverse colon, and the injection was in the Descending colon, they would all be billable. If you have a snare and a biopsy in both the ascending, only the snare would be billable.

    Also, the Snare is the highest reimbursement, as it has the most RVU's, so it would be put first, then the biopsy, then the injection. The regular biopsy and the injection would both receive the 59's, as the above poster suggested. :0)

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