ASGE members may submit coding inquiries electronically to codingquestions@asge.org. Each month ASGE gets dozens of questions from members. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ASGE member’s name and ID number. Only questions will be accepted and not reports. Below are two questions that could be beneficial to your practice.
Question #1
Two polyps were removed during a surveillance colonoscopy. The first polyp was removed by snare but NOT retrieved. The second polyp was removed by cold forceps and pathology revealed an adenoma. Can I charge for the snare even though polyp was not retrieved and what would be the appropriate diagnosis code we should use?
Answer
You can still bill for the snare since the technique was performed. The diagnosis code would be K63.5 since pathology of the polyp is unknown.
Question #2
Here is a frequently asked question: Patient comes in for a pre-colonoscopy screening appointment and some medical issues come up during the visit, for example, occasional heartburn. Should the coder bill the screening codes as primary and medical conditions as secondary, or should the medical conditions be billed as primary because a medical reason was mentioned?
Answer
The medical indications addressed should be primary and a standard E&M visit would be billed based upon decision making or time.