Factors Essential In Deciding Screening Or Diagnostic Procedures In Colonoscopy

The CPT Assistant article have been tremendously informative over the years in helping people who are not doctors, who are not in that clinical environment to understand the different techniques exactly what it is that's going on.

It does not matter how many biopsies you take, you can only use this 80 code one time. Now, this code is used to describe a cold technique with a cold forcep. Remember, cold biopsy forceps, this forcep is not the same as hot.

So we want to make sure that we understand each of these codes so that as we look at we're coding from an operative report or auditing the operative report of the colonoscopy, that we understand the technicalities that go along with each code.

This is the one that we also use if there's not a mention of a particular technique or a mention of a particular device. So this is sort of the catch-all code if the doctor doesn't list the techniques.

Now, if the doctor doesn't list the technique, even though you might know he's using a lasso technique, if it's not in the documentation, you cannot bill for it. You can check the codes. You have to defer to this code. So that's why that documentation is so important.

On our next slide, for the 45381. This is a colonoscopy where we have the submucosal injection. We may use this to tattoo an area so that we can lift it up, so that they can see it better or in subsequent surgery.

So this is an additional technique where we're not actually removing anything but injecting something into it. Notice the injection has a parenthetical S, meaning 1 injection, 2 injections, 10 injections. You can only bill the code once. And we see that for most of these colonoscopy codes. 45382 which is control of bleeding. Now, this is bleeding that was not caused by you. This is control of bleeding such as for diverticulitis or diverticulosis. This is not a little bit of bleeding because you excised a polyp but rather a significant amount of bleeding caused by something else. 45383. This is with ablation. Now, this particular one can be misleading because it only states what techniques the code really shouldn't be used for in many of the descriptors.

It may not be possible to remove a lesion using one of the techniques or maybe the lesion hasn't been biopsied before but rather is ablated. It is just a catch-all code for some of these types of techniques that are not more specifically defined in your operative report that would allow you to use a code that has a higher number. This is also frequently used to describe for a treatment of benign vascular lesion that they see.