Monday, July 19, 2010

FLEXIBLE SIGMOIDOSCOPY - Medicare payment - CPT 45330, 45331

2010 Medicare GI Endoscopy Procedure Reimbursement Guide for FLEXIBLE SIGMOIDOSCOPY



FLEXIBLE SIGMOIDOSCOPY Ambulatory
Surgery Center
Outpatient
Hospital
Physician
Services
Code Procedure Description ASC Facility Fee
(National Medicare Avg)
APC Facility Fee
Schedule
(National Medicare Avg)²
Fee When
Procedure
Performed in
Hospital or ASC
(National Medicare Avg)³
Fee When
Procedure
Performed
in Office
(National Medicare Avg)³
45330 Sigmoidoscopy, flexible; diagnostic, with or
without collection of specimen(s) by brushing
or washing (separate procedure)
 $89.13    0146    $389.25    $60.98    $127.74  
45331 …with biopsy, single or multiple  $245.07    0146    $389.25    $73.97    $160.58  
45332 …with removal of foreign body  $245.07    0146    $389.25    $107.89    $265.22  
45333 …with removal of tumor(s), polyp(s), or
other lesion(s) by hot biopsy forceps or
bipolar cautery
 $357.42    0147    $623.17    $107.89    $268.11  
45334 …with control of bleeding (e.g., injection,
bipolar cautery, unipolar cautery, laser, heater
probe, stapler, plasma coagulator)
 $357.42    0147    $623.17    $162.38    NA*  
45335 …with directed submucosal injection(s),
any substance
 $245.07    0146    $389.25    $89.85    $230.94  
45338 …with removal of tumor(s), polyp(s), or other
lesion(s) by snare technique
 $357.42    0147    $623.17    $139.29    $296.98  
45339 …with ablation of tumor(s), polyp(s), or
other lesion(s) not amenable to removal
by hot biopsy forceps, bipolar cautery or
snare technique
 $357.42    0147    $623.17    $184.03    $312.13  
45340 …with dilation by balloon, 1 or more strictures  $357.42    0147    $623.17    $113.67    $412.45  
45341 …with endoscopic ultrasound examination  $357.42    0147    $623.17    $155.16    NA*  
45342 …with transendoscopic ultrasound-guided
intramural or transmural fine needle
aspiration/biopsy(s)
 $357.42    0147    $623.17    $237.08    NA*  
45345 …with transendoscopic stent placement
(includes predilation)
 $875.58    0384    $1,785.67    $172.48    NA*  

1 comment:

  1. 45330 REJECTING W/DX OF K62.9? ANY IDEAS

    ReplyDelete

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