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Coding 45385, 45383, 45380 and 45380

SuperCoder Posted Thu 11th of December, 2014 15:23:07 PM

Coding 45385, 45383, 45380 and 45380 can all of these be on a claim with a modifier?

SuperCoder Answered Thu 11th of December, 2014 17:09:24 PM

Thanks for your question. Yes you can bill all of these codes on a claim at one time. You would not bill 45380 twice on a claim in any circumstance. 45380; Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple will cover any amount of biopsies performed. Review your documentation to be sure that all of the separate procedures have been documented appropriately. You would need to use a modifier on both 45385 and 45380 as they are column two codes for 45383. Hope this helps.

SuperCoder Posted Fri 12th of December, 2014 15:51:48 PM

Sorry about the two 45380. One of them was supposed to be 45381

SuperCoder Answered Fri 12th of December, 2014 17:23:09 PM

It is possible for these procedure codes to be billed together during the same encounter. Your documentation should support the need for billing each of these procedures separately. See the following links for additional information and coding scenarios.

https://www.supercoder.com/coding-newsletters/my-gastroenterology-coding-alert/you-be-the-coder-45383-45381-take-care-of-same-polyp-intervention-article

https://www.supercoder.com/coding-newsletters/my-gastroenterology-coding-alert/avoid-3-costly-colonoscopy-tumor-removal-coding-mistakes-article

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