General Surgery Coding Alert
Sigmoidoscopy Is Not Reduced Colonoscopy
Pennsylvania Subscriber
Answer: The appropriate code is 45335 (Sigmoido-scopy, flexible; with directed submucosal injection[s], any substance). CPT defines a colonoscopy as extending beyond the splenic flexure, and in this case, the surgeon did not advance that far.
If the surgeon had attempted a colonoscopy, rather than a sigmoidoscopy, you would be correct to report the appropriate colonoscopy code (for example, 45381, Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection[s], any substance) with modifier -52 (Reduced services) appended (Note, however, that Medicare specifies modifier -53 [Discontinued procedure], rather than -52, for an incomplete colonoscopy). But if the surgeon does not intend to perform a colonoscopy (that is, to advance beyond the splenic flexure), the sigmoidoscopy code is more appropriate.
General Surgery Coding Alert
- Part 2:
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