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Polypectomy, 1 technique, 2 sites(colon, rectum)

  1. Default Polypectomy, 1 technique, 2 sites(colon, rectum)
    Medical Coding Books
    Hey all,

    I have seen a charge where another coder showed a snare polypectomy in the colon and the rectum and coded a 45385, and 45385-59 with dx 211.3 and 569.0. Insurance paid on this charge, but is this acceptable? I thought same technique couldn't get paid during the same colonoscopy.



  2. Default
    Don't forget the old coding wisdom: "Just because insurance paid for something doesn't mean it's coded correctly."

    You're right. You can only code a removal technique once per procedure, even if you used the snare to remove numerous polyps located in multiple locations, you can only code 45385 once. However - if you used the snare to remove a polyp in one location and then used the hot biopsy forceps to remove a polyp in another location, then you can code for the 2 separate techniques....45385 and 45384.

  3. Default
    Hey thanks, that's kind of what I figured, but anytime I see something I'm not used to I have an internal freakout thinking I've been doing this wrong all along.


  4. #4
    Bob, I know exactly what you mean! I do the same thing anytime I read something or see something that is different. What I have to do is find as much info as I can in order to support my hypothesis, and sometimes I do find out that I can be doing things just a smidge differently to have better results. It's the game that is coding! But after all that, let me just say that I agree with the other folks who responded, you can't do 2 45385's. I have heard that before, but if you research in the coding companion, and other places, you'll see that that just isn't right. You're doing a good job. :0)

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