tci General Surgery Coding Alert - 2006 Issue 1

You Be the Coder: Is Control of Bleeding Bundled?

Question: Can we gain additional reimbursement if our surgeon performs a flexible sigmoidoscopy with control of bleeding to remove rubber bands within the global period of a rubber-band ligation, or would this be bundled?North Carolina SubscriberAnswer: In this case, you may report the sigmoidoscopy separately using 45334 (Sigmoidoscopy, flexible; with control of bleeding [e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator]). You should append modifier 78 (Return to the operating room for a related procedure during the postoperative period) to 45334 to indicate that the surgeon performed the second procedure because of a...

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