Gastroenterology Coding Alert

Question: My gastroenterologist performed a proctosigmoidoscopy on a patient and removed a rectal polyp. She also performed two cryptectomies. Can I report the hemorrhoid procedures separately from the scope?

Texas Subscriber

Answer: No, you'll have to bundle the cryptectomy in with the more extensive procedure, 45308 (Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery).

When your gastroenterologist scrapes an inflamed area, she performs a cryptectomy. If that's all she does, report this service using codes 46210 (Cryptectomy; single) and 46211 (... multiple [separate procedure]).

But if your gastroenterologist performs one of the services 45300-45392 or 46250-46258 describe in addition to the cryptectomy, you have to include the cryptectomy as part of the more extensive procedure. Correct Coding Initiative (CCI) edits

bundle the services, and the cryptectomy represents the column two or "lesser" service.