Wiki Sig with banding

ENDOCODER

Networker
Messages
44
Location
Sterling Heights, MI
Best answers
0
Need some help. Dr. wants to do a hemorrhoid banding 46221 with a Sigmoid, same visit. Our Coding companion book shows 46221 and CCI edit 45330. 45331 is not listed. Will we get paid if he does a Sig with biopsy and banding 46221 since it doesn't show as an edit? Is claim payable if he just does sig w/ no bx and banding?
 
We are in Ohio and found that most insurance carriers do not cover a Flex Sig or a Colonoscopy when the reason for the procedure is just to band the hemorrhoid. However if there was something else that happened with the procedure such as a biopsy or a polyp removal we have been billing those with a 59 modifier and have been getting payment along with the hemorrhoid banding.

Hope that helps. Thanks, Robin
 
Top