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Return for another colonoscopy modifier

Kevin Posted Fri 21st of February, 2014 13:13:54 PM

Our physician did a colonoscopy on a patient back in August 2013 with a snare removal of a polyp. Patient returned in Feb 2014 to have another colonoscopy for "removal of polyp which was incompletely removed." Patient has Tufts. Would I be correct in using modifier 76 on this?

SuperCoder Answered Fri 21st of February, 2014 18:15:03 PM

For a polypectomy performed during an incomplete colonoscopy, you should use 45384-45385 (removal of tumors, polyps, or other lesions by various techniques) with the reduced-services modifier 52.

Don't Overlook Location

Where your gastroenterologist performs the procedure can also help determine how you handle a cancellation situation.

In an ambulatory surgery center, report the appropriate procedure code for the case and append modifier 73 (Discontinued outpatient procedure prior to anesthesia administration) or modifier 74 (Discontinued outpatient procedure after anesthesia administration), depending on when the physician canceled the case.

Kevin Posted Mon 24th of February, 2014 11:01:48 AM

The service was not an incomplete/cancellation situation. Patient had first colonoscopy with polyp removal back in August of 2013. One polyp was not removed at that time but was biopsied. Patient needed to return for another colonoscopy to remove a polyp that had been biopsied back in Aug. So patient returned now to have that polyp removed. Do I add a modifier to this colonoscopy that was done in Feb 2014 since there was a colonoscopy done less than 1 year ago?

SuperCoder Answered Wed 12th of March, 2014 22:32:29 PM

No need for any modifier here. This is not a screening colonoscopy. Since the global period of August 2013 colonoscopy had lapsed, you need to code fresh polypectomy here.

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