# Colonoscopy coding -



## Hopp (Oct 17, 2008)

Hi Im new to the profession and would like to get some help with coding: My doc performed the following: Colonoscopy to the cecum, hot bx & fulg. colonic polyp midascending colon, snare polypectomy of chronic polyp prox.rectum & cold bx & polypectomy chronic polyp distal rectum       Thanks in advance for your help!


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## j.berkshire (Oct 17, 2008)

Hopp said:


> Hi Im new to the profession and would like to get some help with coding: My doc performed the following: Colonoscopy to the cecum, hot bx & fulg. colonic polyp midascending colon, /snare polypectomy of chronic polyp prox.rectum /& cold bx & polypectomy chronic polyp distal rectum       Thanks in advance for your help!



It sounds as if there were three interventions and based on that interpretation:  one polyp in the midascending colon was addressed with two techniques, but only one code per lesion can be billed, so bill according to CCI instruction:  45384  

Another lesion in the proximal rectum was snared:  45385

And a polyp in the distal rectum was addressed with cold biopsy and (snare?) polypectomy; again only one technique and 45385 was already billed above:  45380 

Then apply your CCI edits indicating each technique was applied to different lesions and your billing would be:  45383, 45385-59, 45380-59.


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## mbort (Oct 17, 2008)

I agree with Jenny


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## Hopp (Oct 20, 2008)

*RE:CCI Edits*

How do you understand the CCI edits?  Which code to apply the modifiers?  Please help and by any chance is there a book that is available.     Thanks for any help. and for helping with the coding.

I thought the codes would be 45385,45384 -59 and 45383-59   ?  Im Confused


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## j.berkshire (Oct 20, 2008)

I would review CMS's CCI page at http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp, go to the Overview section and download the NCCI Policy Manual for Medicare Services.  See Chapter 6 for Digestive Services.  THen I would look at the actual edits which appear on two tables under NCCI Edits - Physicians and review the surgery digestive system chapter.  Finally, I would review the CMS document with instructions on the proper use of 59 modifier at:  http://www.cms.hhs.gov/NationalCorrectCodInitEd/Downloads/modifier59.pdf

I know this seems complicated, but it's vital to know how to use the CCI.  There is software you can buy that will check edits for you, but it's still a good idea to know the CCI rules.


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