Gastroenterology Coding Alert

Question: If a physician performs a colon procedure and marks a tattoo, is there a separate procedure code for this, or do we have to bill the tattoo with the unspecified code with the colon procedure code?

Florida Subscriber

Answer: You don't have to code them separately. Use 45381 (Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection[s], any substance) for the tattoo procedure, says Teresa L. Baker, CPC, ACS-GI, reimbursement adviser at the University of Michigan's department of internal medicine in Ann Arbor.
 
And, if during a colonoscopy procedure the physician both biopsies a lesion and marks it with a tattoo, you should report CPT 45380 (- with biopsy, single or multiple) and 45381 without a modifier. Unlike the biopsy code, the injection code is not bundled into other colonoscopy procedures.