Wiki colon rpt question

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broyal@sc.rr.com

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Can anyone tell me if I shld use only 45385 and not use 45380 and 45381 because it appears the bx and injection was done on the same polyp he snared. Here is how it reads:

A residual single polyp was found in the colon. Saline was injected at the base to raise polyp prior to removal. The polyp was partially removed by cold snare. A bx was taken after unsuccessful removal. The site downstream 2 folds was marked with tattoo.

I feel like it was done on the same polyp. I appreciate any and all advice on this. Thank you so much.
 
colon cpt question

Yes, I agree. You can't bill for the biopsy on the polyp that was partially removed,you would bill for the EMR and tattoo placement. Adding a modifier to the 45381.[59 or XS].
 
Let me expand a little. You are correct about the biopsy being at the same site/same lesion so it cannot be billed. The new EMR code (Endoscopic Mucosal Resection) includes the lifting of the polyp (saline) and the snaring of it. That is why you would use the 45390. The ink injection is allowed at the same site/same lesion so you can bill that too. Supposedly it does not need a 59 modifier, which is why it is allowed on the same lesion. I do not think I would add a 59 modifier because it really wasn't a separate site/lesion so you do not want to claim it was.
 
One more question though. After looking at the parentheticals under these two codes it states I cannot use 45381 w/45390. Now I'm really confused. Thanks for clarifying.
 
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