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Kawanah Posted Thu 30th of November, 2017 12:35:31 PM
Our physician has removed polyps in the colon using two different devices, a snare (code 45385) and cold biopsy forceps (code 45380). Are we able to charge for a polypectomy using both devices (i.e. 45385 and 45380-59)? If not could we charge if the polyps were removed in different sections of the colon and this had a different ICD 10 code. Example: 45385- D12.2 45380- D12.5
SuperCoder Answered Fri 01st of December, 2017 06:16:59 AM

Hi,

As per the CCI edit with column one CPT code 45385 (Flexible colonoscopy with removal of tumor(s), polyp(s), or lesion(s) by snare technique) and column two CPT code 45380 (Flexible colonoscopy with single or multiple biopsies) is often bypassed by utilizing modifier 59. Use of modifier 59 with the column two CPT code 45380 of this NCCI  edit is only appropriate if the two procedures are performed on separate lesions or at separate patient encounters.

So,if u have documentation that supports removal of polyp from different sections of colon you can report with modifier 59.

Hope that helps!

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