Gastroenterology Coding Alert

Question: Our colorectal surgeons periodically perform an anoscopy (46600) and a proctosigmoidoscopy (45300). CCI edits indicate these codes can't be reported together. However, sometimes these procedures are done for different problems being diagnosed. Is there any way to report both codes? Wisconsin Subscriber Answer: No. A "0" indicator in the CCI table means you may not unbundle the edit combination under any circumstances, according to CCI guidelines. In this case, CCI considers anoscopy (46600, Anoscopy; diagnostic,with or without collection of specimen[s] by brushing or washing [separate procedure]) to be part of the proctosigmoidoscopy (45300, Proctosigmoidoscopy, rigid;diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) -- in other words, CCI assumes your surgeons would not fail to examine a patient's anus while performing a the proctosigmoidoscopy. To find which codes are bundled, check out: www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp. Column F tells you whether you can break the bundle by appending [...]