Wiki Incomplete Colonoscopy-In the CPT

[VFarrell]

In the CPT it states a colonoscopy that is incomplete, after full prep for a colonoscopy is done, is billed with a 52 modifier. If the doctor does not go past the splenic does this mean it should be billed as a flex sig 45330 or as a 45378 - 52?

 

[j.berkshire]

If a colonoscopy is planned and the exam is incomplete because the scope does not pass beyond the splenic flexure, I would bill the colonoscopy with modifier even though RVUs are the same as sigmoidoscopy. Note, though, that Medicare requires a -53 modifier for incomplete colonoscopy. For other payers, -52 modifier is more appropriate by definition.

 

[VFarrell]

thank you!