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can you bill a rigid proctosigmoidoscopy w/ mod -59 when done w/lap colectomy?

KATHLEEN Posted Tue 09th of October, 2012 21:04:55 PM

I was told to bill code 45300 mod -59 when dictated in op note along with colectomy of any sort basically. according to CCI edits this is allowed. I am just wondering if it is appropriate and if otheres are billing this way?

SuperCoder Answered Wed 10th of October, 2012 17:57:52 PM

You can’t override any of these new digestive-system edits by attaching a modifier to your claims.The exact Column 1 codes differ slightly for each of these codes. But the comprehensive codes generally include all of the codes in the endoscopy section of digestive surgery (45300-45392).

Component codes include laparoscopic fundoplasty code 43280; bariatric surgery codes 43644-43653, 43770-43774 and 43886-43888; digestive laparoscopy codes 44186-44188, 44204-44212 and 44227; laparoscopic protectomy and proctopexy codes 45395-45402; cholangiography/cholecystectomy codes 47560-47570; abdominal laparoscopy codes 49320-49325; renal laparoscopy codes 50541-50548; and hysteroscopy codes 58541-58554

Because of separate procedure defination in 45300, you use Modifier 59 when billed with colectomy procedures.

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