General Surgery Coding Alert

Question: Our surgeon treated a patient with a temporary colostomy due to diverticulitis. The surgeon performed a colonoscopy through stoma to examine the colon above the colostomy opening, and a flexible sigmoidoscopy to examine the distal colon from the anus up to the diversion during the same visit. Can I report both procedures?

Colorado Subscriber

Answer: Yes, you can. You should report the colonoscopy using 44388 (Colonoscopy through stoma; diagnostic, including collection of specimen[s] by brushing or washing, when performed [separate procedure]) and the flex sigmoidoscopy as 45330 (Sigmoidoscopy, flexible; diagnostic, including collection of specimen[s] by brushing or washing, when performed [separate procedure]).

Remember, 44388 and 45330 do not belong to the same endoscopic family of codes, so carriers should pay 100 percent of the allowable fee for the colonoscopy or $359.12, and 50 percent of the allowable fee for the flexible sigmoidoscopy, which is $84.85 (Medicare Physician Fee Schedule non-facility national rate, conversion factor 35.8043).