Wiki 45383

[willette]

If my doctor removed a polyp by hot snare and then in his dictation states he fulgurated a different polyp by snare - I take it that he cannot charge that due to the same instrument being used?

 

[eescalante]

No. If it is on two separate lesions then you would bill both codes, using the 59 modifier on the second code. Insurance MIGHT deny the second code as being "bundled" but you can appeal this using the NCCI edits and information which states they are billable if on different lesions/polyps.

 

[jojogi]

You could only code two different lesions as long as they were located in two different sites of the colon using the mod 59. If both lesions are at the same site you cannot code using 59, you would only code it once.