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will 211.4 cover 45380?

Mary Posted Fri 02nd of March, 2012 15:08:10 PM

Our physician performed a colonoscopy with biopsy (45380) with resulting colon polyp (211.4)-however, when I researched the coverage under "Code Search" on this site, it states that only 211.3 (rectal polyp)covers this. I also searched on the CMS website and they state that 211.4 is covered. Can anyone help with this? Thank you!

SuperCoder Answered Fri 02nd of March, 2012 16:59:35 PM

ICD crosswalk is the broad categorization of the Dx covered for a particular specific CPT. If your document supports the medical necessity of this Diagnosis, go ahead and code 211.4

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