ED Coding & Reimbursement Alert - 2019 Issue 2
You Be the Coder: Use Just One Polyp Code
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Article Overview
This article explains a colonoscopy coding scenario involving polyp removal with additional treatment for bleeding at the excision site. It is written for coders working with endoscopy claims and CCI edit concerns, and it discusses when a separate procedure code is not reported, as well as the possibility of modifier use in limited circumstances.
Why This Topic Matters
It helps coders interpret documentation that includes both lesion removal and post-procedure hemostatic work, so claims can be reported consistently with edit logic and modifier rules.
What You Will Learn
- How a colonoscopy with polyp removal and additional site treatment is discussed in coding guidance
- How edit relationships can affect whether more than one endoscopy code is reported
- What general modifier considerations may arise in a same-site procedural scenario
- When increased procedural work may be considered in the context of a coding question
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Gastroenterology billing staff
Codes Discussed
Modifiers Discussed
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