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reimbursement medicare screening colonoscopy with polypectomy

Karen Posted Sat 10th of March, 2012 22:12:16 PM

What do we charge? We scheduled a Medicare patient for screening colonscopy. Polyps were removed. Normally would bill CPT'G0105' and DX code V76.51 if it were straight screening. Do we now bill CPT G0105 and DX V76.51 with the increased amount that would accompany a CPT 45385 procedure?

SuperCoder Answered Mon 12th of March, 2012 14:40:53 PM

Since now polypectomy has been performed, bill as 45385 with V76.51 instead of diagnostic G0105

Maarit Answered Mon 12th of March, 2012 18:26:53 PM

Also you should add the path Dx (211.3 if benign) as secondary and use modifier PT on 45385 to indicate that a screening colonoscopy changed to a diagnostic one.

SuperCoder Answered Mon 12th of March, 2012 18:27:55 PM

Yes I agree on that

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