tci General Surgery Coding Alert - 2010 Issue 6

Limit 1 Code Per Colonoscopy -- Unless You Use 2 Methods

Multiple endoscopy rule reduces pay.You shouldn't report polypectomies "per polyp," but make sure you know the following exception so you don't short change your practice when your surgeon can legitimately claim multiple surgeries.Code Definitions Cover Multiple PolypsCPT restricts each polypectomy code ( CPT 45380 -45385, Colonoscopy, flexible, proximal to splenic flexure ...) to one unit per colonoscopy. The code definitions state "polyp(s)" or "single or multiple," which means you should report the code only one time for one or more polyps."The 'one unit' restriction applies even if the surgeon performs polypectomies at several different...

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