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KBand CPC CFPC

  1. Default KBand CPC CFPC
    Exam Training Packages
    I am looking for advice on the correct colonoscopy code selection when the physician dictates "polyps removed by desiccation". Would I use code 45383 "Colonoscopy, flexible, proximal to the splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique", or code 45384 "Colonoscopy, flexible, proximal to the splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery." Any advice is greatly appreciated!
    KBand, CPC CFPC

  2. #2
    Location
    Jacksonville Florida Chapter
    Posts
    205
    Default
    I'd go back to the surgeon and ask exactly how the polyps were removed. Were they removed by hot biopsy forceps, bipolar cautery, or snare technique? If the surgeon gives you a hard time, I'd explain that you need to know in order to code correctly and to get paid.
    John Meyer, CPC
    Heekin Clinic

  3. Default
    I have requested to the surgeon to please specify in the procedure note the method used. However, the response to that is no. I will continue to ask her but since the method is not documented I can only assume I use code 45383. Any other thoughts or suggestions?
    KBand, CPC CFPC

  4. #4
    Default
    Yes I have a suggestion. Tell the doc if they don't tell you how it was done she won't get paid. we all have to live within the rules that are there even if we don't like it.

    I have no idea what removal by desiccation means.

  5. #5
    Location
    Jacksonville Florida Chapter
    Posts
    205
    Default
    Quote Originally Posted by colorectal surgeon View Post
    Yes I have a suggestion. Tell the doc if they don't tell you how it was done she won't get paid. we all have to live within the rules that are there even if we don't like it.

    I have no idea what removal by desiccation means.

    Couldn't have said it better myself.
    John Meyer, CPC
    Heekin Clinic

  6. Default
    Thanks for the advise/suggestions.
    KBand, CPC CFPC

  7. #7
    Location
    Jacksonville Florida Chapter
    Posts
    205
    Default
    Good luck and I hope your provider gets the message.
    John Meyer, CPC
    Heekin Clinic

  8. #8
    Location
    Atlanta Perimeter
    Posts
    59
    Default
    Have you tried actually showing her the CPT book descriptions of the codes? Maybe if she sees how specific the descriptions are and what you have to go by then she'll understand why you are asking. That's worked for me with a couple of our more difficult doctors.
    Elizabeth Escalante, CPC
    Operations Manager
    Atlanta Gastroenterology Associates

  9. #9
    Location
    Jacksonville Florida Chapter
    Posts
    205
    Default
    Quote Originally Posted by eescalante View Post
    Have you tried actually showing her the CPT book descriptions of the codes? Maybe if she sees how specific the descriptions are and what you have to go by then she'll understand why you are asking. That's worked for me with a couple of our more difficult doctors.

    I never thought of that. I for one thank you for the suggestion. I'm going to keep that in mind in case I get a difficult provider for both ICD and CPT coding.
    John Meyer, CPC
    Heekin Clinic

  10. #10
    Location
    Atlanta Perimeter
    Posts
    59
    Smile
    Quote Originally Posted by pogiest View Post
    I never thought of that. I for one thank you for the suggestion. I'm going to keep that in mind in case I get a difficult provider for both ICD and CPT coding.
    You're welcome!

    I also did a bit of research into what "desiccation of polyps" might mean...

    One reference says that desiccation refers to the slight ablation of tissue that occurs during the hot snare polyp removal. (Successful Training in Gastrointestinal Endoscopy By Jonathan Cohen)

    Perhaps she is just referring to a hot snare polyp removal... still you would need clarification in the documentation.
    Elizabeth Escalante, CPC
    Operations Manager
    Atlanta Gastroenterology Associates

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