Gastroenterology Coding Alert
Multiple Procedures
Kathy Ingebretson, Medical Coder
Trident Gastroenterology Associates, P.A.
North Charleston, SC
Answer: For the above example, gastroenterologists should bill for both procedures, says Susan Callaway-Stradley, CPC, CCS-P, a coding consultant and educator in North Augusta, SC. They also should attach modifier -59 (distinct procedural service) to 45380, she says. In addition, according to Callaway-Stradley, the physician must be able to support the modifier use with documentation showing that the biopsy is for a lesion separate from the one removed in during the 45385 procedure.
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