With each New Year comes a fresh batch of CPT updates. The three GI sister societies have released a report on 2015 coding updates for gastroenterologists to know. Here are 17 colonoscopy coding updates to know.
• New definition. The new definition designates a colonoscopy as the examination of the entire colon. For screening or diagnostic colonoscopy, use 45378 with modifier 53 if unable to advance past the cecum or small intestine anastomosis. For therapeutic colonoscopy, use appropriate code with modifier 52 if 53 if unable to advance past the cecum or small intestine anastomosis.
• CPT code 45399. This code has been deleted. The new code for unlisted colon procedure is 45399.
• CPT code 45378. Colonoscopy is examination of the entire colon.
• CPT code 45379. "Foreign body(s)" replaces "foreign body."
• CPT code 45380. Biopsy, not separately reportable with EMR code 45390 for the same lesion.
• CPT code 45381. Submucosal injection, not separately reportable with WMR or control of bleeding codes 45382 and 45390 for the same lesion.
• CPT code 45382. Control of bleeding, "any method" replaces previous examples. Not separately reportable with 45381 or 453938 for same lesion.
• CPT code 45834. Hot biopsy, bipolar cautery was deleted as an example.
• CPT code 45385. Snare, not separately reportable with EMR code 45390 for same lesion.
• CPT code 45386. Dilation, use modifier 59 for each additional stricture dilated. Not separately reportable with 45388 or 45389. If fluoroscopic guidance is used, use 74360.
• CPT code 45388. Ablation, code 45383 has been deleted. New code 45388 includes balloon dilation, guide wire insertion and ablation.
• CPT code 45389. Stent placement, code 45387 has been deleted. New code 45389 includes pre- and post-dilation and guide wire passage. Not separately reportable with 45386. If fluoroscopic guidance is used, use 74360.
• CPT code 45391. Endoscopic ultrasound now specifies exam limited to the rectum, sigmoid, descending, transverse or ascending colon and cecum and adjacent structures. Report only once per session.
• CPT code 45392. Endoscopic ultrasound with FNA. Endoscopic ultrasound, now specifies exam limited to the rectum, sigmoid, descending, transverse or ascending colon and cecum and adjacent structures. Report only once per session.
• CPT code 45390. Endoscopic mucosal resection, new code 45390 is not separately reportable with 45380, 45381 or 45393 for the same lesion.
• CPT code 45393. Decompression, new code 45393 for pathologic distention. Report only once per session.
• CPT code 45398. Band ligation, new code 45398 not separately reportable with 45334 for the same lesion. Do not report in conjunction with 45390 or 46221. Report active bleeding with band ligation with 45382.
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