# Colonoscopy with EGD - I may have an answer



## fredcpc (Dec 13, 2010)

I may have an answer on this, but would like to confirm my answers. The Scenario: Colonoscopy snare polypectomy in the ascending colon, then a biopsy in the sigmoid colon. Also, a Diagnostic EGD. All same physician, same session. Any thoughts?


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## btadlock1 (Dec 13, 2010)

fredcpc said:


> I may have an answer on this, but would like to confirm my answers. The Scenario: Colonoscopy snare polypectomy in the ascending colon, then a biopsy in the sigmoid colon. Also, a Diagnostic EGD. All same physician, same session. Any thoughts?



45385 (Code to the furthest extent of the procedure)
43235/59

Correct?


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## fredcpc (Dec 13, 2010)

*Colonoscopy with EGD*

Thank you. I like your solution, and it may get a quicker payment. But the C-scopy snare is in the ascending colon and the biopsy is in the sigmoid colon. Separate parts of the colon. Then add the EGD. So....

45385
45380-59
43235-51

Any thoughts?


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## btadlock1 (Dec 13, 2010)

I'm not sure that the location of the biopsies and polyps matters as much as the method - the code I mentioned is only for snare technique, so if the biopsy  wasn't taken that way, then my first answer won't work...and now I'm not around my codebooks, so I can't offer much else on the subject at the moment...


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## fredcpc (Dec 13, 2010)

*Colonoscopy with EGD*

Thanks for the input.


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## Candice Peckham (Dec 13, 2010)

All EGD's are diagnostic. Only colonoscopies can be done as a screening. Just some info. Hope it helps.


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## fredcpc (Dec 13, 2010)

*Colonoscopy, Medicare, G0121*

You are right. The EGD was diagnostic. I feel that has to be coded in addition to the Colonoscopy. Do you agree?


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## btadlock1 (Dec 13, 2010)

They have different approaches, so there's no reason they can't both be billed.


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## bdobyns (Dec 15, 2010)

If the biopsy was done with seperate technique and on a seperate lesion then the apporopriate coding would be as follows:

45385
45380-59
43235-51


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## fredcpc (Dec 15, 2010)

*Colonoscopy with EGD*

Thank you for your and confirmation. I had the same codes.


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## JenReyn99 (Dec 16, 2010)

I agree with bridobgastro, the biopsy and the snare were in two separate locations and by name and nature two separate techniques, so they are both separately billable. An EGD is always billable when done in the same session as a colonoscopy, because they are by nature two very distinct procedures. I code these all the time. The codes would be exactly as bridobgastro said. :0)


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