Forum - Questions & Answers
Colonoscopy
Can you bill a colonoscopy with a modifier if more than one polyp was removed? If so which modifier would I use. Procedure is 45384. The reason I am asking this one of our Drs was @ a seminar and someone there told him that they bill theirs with a 59??
look to technique and procedure(s)
The code states lesion(s) and includes single or multiple lesions, this is billed only once.
45384 - Colonoscopy, flexible, proximal to the splenic flexure; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery.
What is heard is sometimes misinterpreted.
Modifier 59 and colonoscopy
When tumors or polyps of different sizes are removed from different sites in the colon, clinical circumstances might require that different techniques be used. In these instances, it is appropriate to report both codes 45384 and 45385, as an example. Modifier 59 (distinct procedural service) is used to identify different procedures/services that are not normally reported together, but are appropriate under the circumstances as different techniques were used on separate sites. The appropriate coding reports the higher valued of the procedures first, unmodified, and add the -59 modifier to the second or subsequent service(s) to indicate that it is
separately reportable.
Colonoscopy
Take a look at the article on colonoscopy. I've added some of the Q&A about the procedures at the bottom of the article.