What is the difference between CPT 45380 and 45378?

Insurance billing codes for screening colonoscopy have two components. For example, code 45378 applies to a colonoscopy in which no polyp is detected, while codes 45380-45385 apply to colonoscopy that involves an intervention (e.g., 45385 is the code for colonoscopy with polypectomy.)

Does CPT code 45380 need a modifier?

As with any coding, modifiers should be used only when the medical record documentation clearly supports them. This is especially important because modifiers often affect the CPT/HCPCS code level of reimbursement.

Can 45380 and 45388 be billed together?

True Blue. If the issues removed were the same ones you are wanting to bill as biopsies then no. If you removed some and then biopsied other areas then yes you can bill together with a modifier.

What is the difference between 45380 and 45385?

45380—Colonoscopy, with biopsy, single or multiple. Hint: The physician may use the words “biopsy forceps,” or “Jumbo forceps.” Fee amount $468.96. 45385—Colonoscopy, with removal of tumor(s), polyp(s), lesion(s) by snare technique. Hint: This code covers both cold and hot snare.

Can CPT 31623 and 31624 be billed together?

Based on 2003 CPT text, Surgical bronchoscopy always includes diagnostic bronchoscopy when performed by the same physician. Therefore, if 31622 is submitted with 31623-31656–only 31656 reimburses. Anthem Central Region does not bundle 31623 with 31624.

What is Procedure Code 45378?

The Current Procedural Terminology (CPT) code 45378 as maintained by American Medical Association, is a medical procedural code under the range – Endoscopy Procedures on the Rectum.

What does 45378 mean?

CPT code 45378 is the base code for a colonoscopy without biopsy or other interventions. It includes brushings or washings, if performed. It includes brushings or washings, if performed. This modifier also may be appended to therapeutic colonoscopies, such as 45385 (colonoscopy, with removal of tumor, polyp, or other lesion by snare technique).

What is CPT code 45385?

The Current Procedural Terminology (CPT) code 45385 as maintained by American Medical Association, is a medical procedural code under the range – Endoscopy Procedures on the Rectum.

What does Medical Service code 43239 CPT stand for?

If an EGD is performed with a biopsy, and then the physician removes the scope and performs an Esophageal Dilation by unguided sound, it should be billed using two CPT codes – CPT code 43239 for the EGD with a biopsy and code 43450 for the Esophageal Dilation.