Wiki 45390

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Use of 45390

The procedure notes that I have seen where the physician is using 45390 has been incorrect. After a great deal of research with another CPC, we discovered that each of these patients actually had a 45385 and 45381. The patient received a saline injection with snare polypectomy. The physicians have been choosing 45390 which is a mucosal resection and was not correct for the procedure performed. You may want to closely review the actual procedure note to see if this is the case for you. 45385 and 45381 can both receive a 33 modifier if the original diagnosis code was Z12.11 and the patient is not Medicare.

Hope this helps.
 
45390 versus 45385 and 45381

Read the notes carefully. You want to see notes such as "flat plyp" "injection of saline" for a "lift technique" "mucosal resection" "snare technique" procedure was "complete/incomplete" and I would also want to see extra work such as "clips were used to prevent bleeding". Maybe this makes it a bit more clear.
 
Mhardy1964 said:
The procedure notes that I have seen where the physician is using 45390 has been incorrect. After a great deal of research with another CPC, we discovered that each of these patients actually had a 45385 and 45381. The patient received a saline injection with snare polypectomy. The physicians have been choosing 45390 which is a mucosal resection and was not correct for the procedure performed. You may want to closely review the actual procedure note to see if this is the case for you. 45385 and 45381 can both receive a 33 modifier if the original diagnosis code was Z12.11 and the patient is not Medicare.

Hope this helps.
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Thanks so much for your input but if it truly is coded correctly with 45390 has anyone seen something stating that you can't bill with either a 33 modifier or a PT modifier?
 
Thanks so much I had not been able to locate anything stating you could not bill with either modifier.
 
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