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Any help would be appreciated as I havent come across this yet.
Thank You
I’ve a case where the encounter is for screening colonoscopy (ICD-10-CM: Z12.11). The surgeon found a polyp (ICD-10-CM: K63.5) in the transverse colon and excised it using snare (CPT 45385). Pathology report comes a few days later and states the excised tissue as "normal colonic mucosa".
Did the surgeon excised normal tissue only and if that is the case what would be the codes? Should we code for biopsy only and not snare since there was no lesion that was excised and was rather normal tissue?
I’ve narrowed it down to:
1. ICD-10-CM: Z12.11, K63.5; CPT: 45385; OR
2. ICD-10-CM: Z12.11; CPT: 45380
Any insights?
Thanks!
Amber
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Thank you in advance for your help. I am pulling my hair out at this point.
Is there something I don’t know here, or is he committing fraud?
"Again, Dr. >____ assisted with patient positioning, prepping and draping, retraction, closing and dressing application. It was necessary to have him there as an assistant."
There is no mention of the assisting surgeon in the procedure description, just that note at the end. Is this enough to justify having him as an assistant?
Please advise. Thanks!
Deb Larsen, CPC
"Again, Dr. >____ assisted with patient positioning, prepping and draping, retraction, closing and dressing application. It was necessary to have him there as an assistant."
There is no mention of the assisting surgeon in the procedure description, just that note at the end. Is this enough to justify having him as an assistant?
Please advise. Thanks!
Deb Larsen, CPC
thanks for any/all insights.
jro
CPT guidelines state that this code should not be coded with a -62 modifier.
Has anyone ever tried to bill this code for a Co-Surgeon and been paid?
Thanks for any input