Forum - Questions & Answers

Sep 6th, 2016 - Hgpc1007 2 

multiple polypectomy

Cannot figure out why we are not getting any additional payment for multiple polypectomy, even though we are appending modifier 22, describing the number and the location under claim notes. There were times when we even attached procedure report, still no additional payment. Could use some advise. Thank you.

Sep 6th, 2016 - lkoolsone 11 

re: multiple polypectomy

If you use two different polyp removal methods, you would append modifier 59 to the second procedure code. If you are just removing several polyps with the same method, additional payment is not available.

Sep 6th, 2016 - rphelps 615  1 

re: multiple polypectomy

Also if you are using modifier 22 because of an excessive amount of polyps, you also have to attach a note explaining why you think you should be reimbursed such the amount of additional it took because of multiple polyps.

Sep 7th, 2016 - Hgpc1007 2 

re: multiple polypectomy

Thank you all so much for your prompt replies. Will definitely try them out and see.

Sep 6th, 2016 - ccrider 6 

re: multiple polypectomy

the CPT® code is for polyp(s) removal. so multiple polyps removed are already covered. Modifier 22 isn't usuable. Also, the other person who replied is correct. You can bill multiple removals if the method & area(s) are distinct from each other...for example polyp in transverse colon by snare would be separately billable from polyp in sigmoid by hot bx forceps using modifier 59 PROVIDED the doctor has correctly documented same in the body of their operative report. Each polyp now has there own dx code-thanks to ICD-10.



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