Wiki Colonoscopies - I read an interesting post

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lngast

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I read an interesting post from 2011 and wanted to know if the same was still true. Can I bill more than one colonoscopy code w/59 mod to indicate that a biopsy or polyp was removed on different parts of the colon by different means...45380-59 with 45384-59 and 45385?
 
Hi,

In colonoscopy procedures, multiple CPT can be used only when multiple techniques have been used to remove the polyp / lesion.

If multiple polyps from different location of intestine are removed with same technique, then it can be coded with only one CPT which represent that technique.

If multiple polyps from different location of intestine are removed with
different techniques, then it can be coded with multiple CPTs.

So, number of techniques decides the number of CPTs, not the number of polyps.

Hope it gives a little more clarity of your view
 
Can someone help me out? Dr did colonoscopy biopsy taken with cold forceps and a polyp removed with a hot snare. I billed it out as 45385 and 45380-59 and I received a denial stating incorrect modifier coding.
 
From a CPT coding perspective, if the same lesion is biopsied, and subsequently removed during the same operative session, then you should only report the code for the removal of the lesion. However, if one lesion is biopsied, and a separate lesion is removed during the same operative session, then it would be appropriate to report a code for the biopsy of one lesion, and an additional code for the removal of the separate lesion.

Under certain circumstances the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day. Modifier -59, Distinct Procedural Service, is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. This may represent a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same physician. Therefore, if one lesion is biopsied, and a separate lesion is removed, then it would be appropriate to append modifier -59 to the code reported for the biopsy procedure
 
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