Wiki 45398 colonoscopy w/band ligation

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LBrager

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Can anyone tell me where to find the RVU's listed for this new code? Also my docs are questioning what it really means. I interpret it to be if you band a hemorrhoid in the same setting as a colonoscopy. I looked on AMA, CMS and AAPC website and I cant find any documentation on this new code. Any help would be appreciated.
 
From what I have read CPT 45398 TC w/band ligation will not have any CMS RVU's assigned for 2015 and will need to be reported with G6021-unlisted procedure, intestine. G6021 MPFS status is "C" which means it will be contractor priced.(will have to support code with report when billing) This applies to Medicare patients. Have not yet heard anything about how commercial payers will treat the new codes.
 
Banding

If my doctor has done an EGD with bx and a colonoscopy with banding can you tell me the proper way to code this? Thanks.
 
45398

I attened Kathy Muellers conference in Jan 2015 in St. Louis and she stated that the code 45398 is surgical banding and not the CRH banding that is non surgical. I have seen a few denials for 45378 and 46621 billed together stating that we should use the 45398. I am not sure if this is a payer edit error and misunderstanding of the code. I have reached out to Kathy about this. Anyone else had this issue?
 
I am just confused on how I should report these codes now and I cannot find anything that helpful. I would code before as the colonoscopy 45378-45385 (are the normal codes my docs use) then I would also code the 46221. So now for 2015 how would I code this...

would I code just the G6021 or just the 45398 depending on the insurance.

Any help would be greatly appreciated.

Thanks
Diana
 
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