One of our Gastroenterologist performed a follow up colonoscopy on an est. pt with a 10 year history of ulcerative colitis. The physician removed a 3 mm polyp with cold biopsy forceps in the sigmoid colon. He also obtained biopsies every 10 cm because of the pts. longterm ulcerative colitis. The charge was 88305 x 13 units and 88312x 1 unit. Medicare paid for the 88312 and denied 88305.
I have tried to find the actual policy regarding maximum unit edits and have been unable to find it. I want to make sure I use modifier 59 correctly. Any advice you can give me would be appreciated.