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Thread: diagnostic anorectal exam and laparo colotomy

  1. #1

    Default diagnostic anorectal exam and laparo colotomy

    AAPC: Back to School

    need some input. i have a surgeon who is charging out a 45990 and 44238 (unlisted procedure, removal of foreign body, done laparo colotomy)

    would the 45990 be bundled into the main procedure?? i'm trying to find something on this. any feedback would be great.

  2. #2
    Join Date
    Apr 2007


    In my opinion

    If the anorectal exam initiated before the lap colotomy for the decision to continue with, then I think its reportable with a modifier 58 if there is a CCI edit and depending on carrier.

    Refer to NCCI document


  3. #3


    thanks, MS.
    that's what i thought too.
    will review some more.

    thank you!

  4. #4


    wait. did you mean mod -59?
    both procedures were done the same day....same op session.
    anorectal exam was done before the lap colotomy.

  5. #5


    nevermind. i figured it out. i'm not charging the 45990 out separately. the way i see it in the op note is this is more a of a "scout" procedure...exploration of the surgical field. I will only code out 44238. Thanks!

    I READ THE NCCI like you suggested.

  6. #6
    Join Date
    Apr 2007


    Instructions says to use 58 when endoscopic diagnostics will be utilized when it should be bundled. Yes NCCI document is our best friend...Call me Marie


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