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Thread: Poor prep colonoscopy with polypectomy

  1. #1
    Join Date
    Apr 2007
    Lehigh Valley

    Default Poor prep colonoscopy with polypectomy

    AAPC: Back to School
    I am unsure how to bill this to Medicare. The patient underwent a colonoscopy. Endoscope was inserted into anus and air insufflated. Immediately encoutered was solid stool. Endoscope could only be advanced to level of 30 mc due to inability to visualize the colonic lumen. A 3 mm sessile polyp was identified at 20 cm from the anal verge and was removed using snare electrocautery and retrieved. Exam was terminated and needed to be repeated in the future after repeat prep.

    Would I use the colonoscopy with polypectomy code 45385 with a 53 modifier to use 45338 code. I need to let Medicare know that this was an inadequate prep and that she will need to have a repeat procedure done.

    Thanks in advance for your help!

  2. #2
    Join Date
    Apr 2007
    Lauderdale Lakes


    The 45385 with 53 modifier is correct

  3. #3
    Join Date
    Apr 2007
    Lehigh Valley


    Thanks! This is what I thought...just wanted to be sure.

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