Wiki Coding Help Please

[torihamill]

My provider shows:
Three sessile polyps removed with a jumbo cold forceps
Two sessile polyps removed hot snare
Different sizes and both in rectum

Three sessile polyps removed hot snare in recto sigmoid colon (diff size)

Five sessile polyps removed hot snare in transverse colon (diff size)

Coded as
45385
45380-59

TriWest is denying the 45380-59 as included in the primary procedure. Please help with coding.

Thank you
Tori

 

[garmab06]

you might look at your diagnosis

 

[afalcon@dhcla.com]

I would send clinicals and when entering charges make claim notes that will appear on claim form. Some insurances companies will only pay the highest RVU. check with insurance company