I’ve two questions regarding these codes:

1. If both CPT 45390 and 45385 have been performed on the same lesion, should we code only CPT 45385 since CPT Code 45385 is column 1 and CPT Code 45390 is column 2 code. Also, CPT Manual instruction states, "Do not report 45390 in conjunction with 45385 for the same lesion." But, CPT 45390 has an RVU lower than that of 45385. Does RVU matter while deciding such cases?

2. If CPT 45390 and 45385 have been performed for different lesions then with which CPT should we append the modifier 59 (or XS) and what would be the sequence? Should we code: a) 45385, 45390-59 (XS), b) 45390-59 (XS), 45385 or c) 45390, 45385-59 (XS)?

Thanks!

Amber