tci General Surgery Coding Alert - 2001 Issue 4

Reader Question: Endoscopy, Colonoscopy During Same Session

Question: The January 2001 General Surgery Coding Alert, p. 3, provides an example of the multiple endoscopy rule in which payment is calculated for a colonoscopic biopsy performed at the same time as a colonoscopic polypectomy. Payment for the secondary procedure (45380) is determined by subtracting the payment for the base procedure (45378). This raises a further question: What is the rule when an upper endoscopy is performed at the same time as a colonoscopy? The colonoscopy is the higher reimbursed service. How is payment calculated for the upper endoscopy (there is no base code to be subtracted from...

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