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GI procedures that take longer than normal (Coding question)......very important

Melanie Posted Wed 24th of February, 2010 14:31:15 PM

The verbiage of the GI procedures does not describe time....

BUT... I have a physician who seems to think there is an Add-On code that we can use to show that the procedure took longer than normal?

He had a case last week that took him an hour to do on a Colonoscopy that had multiple procedures for polyps/issues in different parts of the colon using different techniques... and wanted to find out if we can code for the additional time?

Ive never heard of an add-on code to accomodate this ..

Any input would be great!

SuperCoder Answered Wed 24th of February, 2010 18:00:34 PM

I don't think that there is an add-on CPT for extra time involved during a colonoscopy procedure. In the colonscopy section there are several codes which can be used for different techniques. But if the physician invests extra time during this px then, in this case you can use a modifier 22 appropriately that can allow the physician to receive additional compensation for the additional work he performed. An extra supporting document must be submitted along with this claim which should include a separate section -- entitled “special circumstances” or something similar -- that precisely explains, in clear language, how much and why additional time and/or effort was necessary.

Melanie Posted Wed 24th of February, 2010 22:38:20 PM

thankfully we dont run into this all the time, but for advanced colorectal surgical procedures on our elders, we risk such injuries to them if we rush on their complicated issues...

This is very helpful Alex - I actually told my physician this but evidently he doesnt trust me enough on this.... but at least my supervisor did when she 'quizzed' me on it~! LOL

This will help reinforce what I told the physician - now its up to him to play nice LOL

Thank you Alex - take care 8-)

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