This page addresses follow-up questions and additional information pertinent to our webinar
Looking Down the Scope at GI Colonoscopy and Hernia Cases!.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
A: Parastomal hernia repairs are categorized in the anterior abdominal hernia repair code set. Parastomal hernia repairs have their own codes, 49621 and 49622. The anterior abdominal hernia repair codes and parastomal hernia repair codes do have an NCCI modifier indicator of 1. This means that an appropriate modifier is required to bypass the edit. Add a modifier 59 to the second CPT code.
Q: How would a robotic-assisted hernia repair be coded?
A: There are no codes to specifically represent only robotic-assisted hernia repairs. Parastomal and anterior abdominal hernia repair code sets include a robotic approach. For inguinal hernia repairs, select the code that accurately describes the same procedure via a laparoscopic approach.
Q: If a diagnostic colonoscopy is performed and a hemorrhoid is noted and the Provider then removes the colonoscope and then inserts an anoscope to band the hemorrhoid, is it appropriate to report 45398? The band ligation was not done through the colonoscope.
A: This is a common question that has been addressed by a CPT Assistant. Code 45398 is only reported if the band ligation was done through the colonoscope. In this case, if the diagnostic colonoscopy did reach the cecum, report 45378 for the diagnostic colonoscopy. Then report 46221 for the band ligation done through the anoscope.
Looking for additional information on this topic?
Emily Lomaquahu, CPC, CPMA, CEDC
Senior Coding Quality Auditor & Educator
Emily is a Senior Coding Quality Auditor for Haugen Consulting Group and brings over a decade of experience to the profee team! She began her career as an auditor and with her keen eye for detail, she quickly found it was a perfect fit. Emily thrives in a collaborative environment and enjoys creating high-quality trainings to help providers and coders navigate charts and improve their accuracy. She earned a bachelor’s degree from the University of Colorado, in Denver. Emily specializes in Evaluation and Management (E/M), Primary Care, Anesthesia, Emergency Department, and Neurology, though she says Anesthesia and Neurology are her favorites! She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), and Certified Emergency Department Coder (CEDC).
0 Comments