Gastroenterology Coding Alert

Question: How would you code a Barrx Halo and a snare polypectomy when the Barrx Halo was not done to control bleeding?

Ohio Subscriber

Answer: You are not clear in indicating what purpose the Barrx Halo was used by your gastroenterologist. If he used the ablator only as a secondary treatment after the snare polypectomy to ablate the tissue after removal of the polyp, then you cannot report this procedure separately as it is part of the therapeutic maneuver to remove the polyp and is not a separate procedure by itself. So, in such a case, you will only report 45338 (Sigmoidoscopy, flexible; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique) to report the removal of the polyp using the snare.

Even if your gastroenterologist used the Barrx Halo to control bleeding, you cannot report it with 45334 (Sigmoidoscopy, flexible; with control of bleeding [e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator]) as it again part of the same procedure.

However, if your gastroenterologist used the ablator to remove a different polyp from a different site, you can report the snare removal and the ablation separately. So, you will have to report 45338 for the removal with the snare and 45339 (Sigmoidoscopy, flexible; with removal of tumor[s], polyp[s], or other lesion[s] not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique) for the ablation. But, Correct Coding Initiative (CCI) edits bundle 45338 and 45339 with the modifier indicator ‘1,’ which you can unbundle by using the modifier 59 (Distinct procedural service) to 45338.

So, check with your practitioner if the documentation is not clear to see what purpose your gastroenterologist used the Barrx Halo. Depending on the reason for usage, you can either report the procedure with 45339 or not report it at all.