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The Field Guide to Physician Coding 2nd Edition


Forum Discussion Areas > Ask Us a Question > Gastro coding
  Gastro coding
lleos
Gastro coding
Posted:
Jun 26 2012, 1:13 PM
When a physican does a colon and does a poloyectomy (45385) BX (45380) and a tatoo /submucosal inj (45381) do we use a 51 or 59 modifier? On the same day the physican does a upper endo with dialation and a bx (43249) (43239) on the same day and same time, what modifer would i use to bill? CPT® MOD Ex: 45385 / 45380 / 59 45381 / 59 43249 / 43239 / 59 this is the way i was told but i would think it should be a 51 modifier? please advise thanks

 
mesalamb
re: Gastro coding
Posted:
Jun 26 2012, 2:34 PM
I agree with the way you were told.

45385 45380-59 45381-59 43249 43239-59

I never use modifier 51. It is automatically assigned by some payers. I use modifier 59 for multiple procedures done at the same session.

 
rphelps
re: Gastro coding
Posted:
Jun 26 2012, 4:26 PM
There are no bundling issues with 45385,45380 and 45381 so I do not use a 59 modifier on 45381.

 
koatsj
re: Gastro coding
Posted:
Jun 26 2012, 4:31 PM
There are bundling issues with 45385 & 45380. I use -59 modifier on 45380.

 
rphelps
re: Gastro coding
Posted:
Jun 28 2012, 10:21 AM
I agree. 45380 need 59 if done with 45385 but no modifier needed with 45381.

 

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