Gastroenterology Coding Alert

Reader Questions:

Decompression Bundled Into Colonoscopy Code

Question: A patient presented with a pseudo-obstruction in the colon. The gastroenterologist placed a decompression tube via guidewire during a colonoscopy. Can we report separate codes for the colonoscopy and decompression tube placement?

Arkansas Subscriber

Answer: You should not report the colonoscopy and tube placement independently. On the claim, report only 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]) for the procedure. According to CPT's definition, 45378 is the code to report when the gastro performs a diagnostic colonoscopy "with or without decompression."
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