Gastroenterology Coding Alert
Tackle This Injection and Colonscopy Scenario
Question: During colonoscopy, the gastroenterologist finds a polyp in the cecum. He removes the polyp using snare technique. During the same session, while investigating the transverse colon, the gastroenterologist sees a suspicious area that he injects with India ink. How should we code this?
Maryland Subscriber
Answer: You should report 45385 (Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique) for the colonoscopy with polyp removal. And you may submit 45381 (... with directed submucosal injection[s], any substance) to represent the injection.
The National Correct Coding Initiative (NCCI) does not bundle 45381 to 45385, and therefore you shouldn't need to add modifier 59 (Distinct procedural service) to 45381. The polyp removal and India-ink injection are separate procedures.
If your payer rejects the claim, be sure to point to the NCCI as evidence that these procedures are not bundled.
Gastroenterology Coding Alert
- Learn the Ins and Outs of Coding Gastro Clips--Their Use Makes All the Difference
Cut out unnecessary steps when reporting endoscopic marking clips
If your gastroenterologist uses clips to control [...] - Curb Incomplete Colonoscopy Modifier Mishaps With This Advice
Distinguish incomplete from cancelled procedures -- here's how
When you-re not charging for the full colonoscopy, [...] - Dodge Critical Care Mistakes by Avoiding These 2 Myths
Here's what you need to have -- and don't -- when reporting critical care
If you [...] - READER QUESTIONS:
Learn 1 Exception to Fluoro, ERCP Bundles
Question: One of the physicians in our practice performed a diagnostic endoscopic retrograde cholangiopancreatography (ERCP). [...] - You Be the Coder:
Can You 'Share' a Consult?
Question: I know that a nonphysician practitioner and a surgeon can -share- an E/M visit, [...] - READER QUESTIONS:
Looking for EUS Codes? Find Them Here
Question: What is EUS, and how should I code for it?
Ohio Subscriber
Answer: EUS is [...] - READER QUESTIONS:
Tackle This Injection and Colonscopy Scenario
Question: During colonoscopy, the gastroenterologist finds a polyp in the cecum. He removes the polyp [...] - READER QUESTIONS:
How To Report Smoking Cessation Counseling
Question: We-re not having much success getting paid for smoking cessation counseling when our physician [...] - READER QUESTIONS:
Nix Neoplasm Coding Woes
Question: I-m confused about how I should report malignant and benign stomach neoplasms. How should [...] - READER QUESTIONS:
Gastric Aspiration Calls for 91105
Question: An established patient comes to the office complaining of rectal bleeding. The physician performs [...]
