CPT Code 45380 with 45382 with modifier 59

Medicare denies these two together even with modifier. Can you tell me a better way to get reimbursement for these?

Cci

According to CCI they should not be billed together even though a modifier is allowed. Here is a cut and paste from CCI. Hope it helps!

2. If multiple endoscopic services are performed, the most comprehensive code describing the service(s) rendered should be reported. If multiple services are performed and not adequately described by a single HCPCS/CPT code, more than one code may be reported. The multiple procedure modifier -51 should be appended to the secondary HCPCS/CPT code. Only medically necessary services may be reported. Incidental examination of other areas should not be reported separately.
3. If the same endoscopic procedure (e.g., polypectomy) is performed multiple times at a single patient encounter in the same region as defined by the CPT Manual narrative, only one CPT code may be reported with one unit of service.

45380 and 45382 procedures billed together

If the bleeding comes from a source other than the polyp that was removed you may be able to request a Medicare redetermination (we do this in Michigan). You would then be able to supply op notes. But if the bleeding is from the removal of the polyp there is no way to get 45382 paid.

re: CPT® Code 45380 with 45382 with modifier 59

Hello. We were having that same problem. After review, and research we started putting the 59 modifier on the control of bleeding, when snare, or bx is done at the same time. So far we have been receiving payment from Medicare. Even for the upper endoscopy control of bleeding for avm's we put the 59 on control of bleeding if more than once procedure is done, I hope this helps. Have a great day.