tci General Surgery Coding Alert - 2021 Issue Q4

Reader Questions: Use Caution with Complication Billing

Question: Our surgeon performed a flexible sigmoidoscopy with the intention of performing band ligation of internal hemorrhoids. However, during the procedure, the surgeon caused active variceal bleeding, which they treated with sclerotherapy, and did not complete the band ligation. Should I report both 45350 and 46500? Arkansas Subscriber Answer: No, you should not report both 45350 (Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)) and 46500 (Injection of sclerosing solution, hemorrhoids) for this case. Instead, you should report 45350 with modifier 53 (Discontinued procedure). You should get some reimbursement for the service, but the amount will probably vary from payer...

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