I work for a Gastroenterologist who recently performed a follow up colonoscopy on an est.
pt with a 10 year history of ulcerative colitis. The physician removed a 3 mm polyp with cold biopsy forceps in the sigmoid colon. He also obtained biopsies every 10 cm due to the patients long history of ulcerative colitis. The charge was 88305 x 13 units and 88312 x1 unit. Medicare paid for the 88312 and denied 88305.
I have tried to find the actual policy regarding maximum unit edits and have unable to find it. I want to make sure I use modifier 59 correctly. I would appreciate any help I can get.
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