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southbaymed

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Hi everyboy
:)Happy new year & wishing all of you of best of 2010.
by the way, at AAPC Gastro coding a few years ago, polyps removed from
colon(2113) rectum(2114) can be charged separately w/59 was assured OK.
However, suddenly many ins companies are dening.??? Does my understanding is now obsolete??
Thank you for your help.
 
The polyps have to each be removed by a different method in order to charge for both with a -59. For example, one was cold biopsy and the next one was removed by snare or hot biopsy. Only then can you charge for both. If you have access to CPT Assistant, check in there. It will describe it a lot better and more difinitive. If not, google it and see what you can come up with for references:)
 
More and more companies are requiring documentation when removing polyps using different techniques. I know Cigna and Optima are wanting a copy of the operative note now before they will pay any claims with 45385 and another polyp removal or biopsy code (45384, 45380). They are using "Claimcheck" now for all of their edits and it is kicking out all of those claims until the op note is reviewed to check that there was more than one polyp and more than one technique was used. Bottom line we are coding correctly but the insurance companies want to keep our money just a little bit longer.
 
Thank you for your comments. What I understood was polyp removed
from stomach(2111) and go to Dueod(2112) can be charged because
the different body site. & before we got paid; however, 2009 ins. com just
ignore??
 
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