What is a distinct procedural service?

Modifier 59 Distinct Procedural Service indicates that a procedure is separate and distinct from another procedure on the same date of service. Typically, this modifier is applied to a procedure code that is not ordinarily paid separately from the first procedure but should be paid per the specifics of the situation.

What are the new 2020 CPT codes?

Additional CPT changes for 2020 include the new codes for health and behavior assessment and intervention services (96156, 96158, 96164, 96167, 96170 and add-on codes 96159, 96165, 96168, 96171).

What is the CPT code 45380?

Diagnostic / Therapeutic Colonoscopy – Patient has gastrointestinal symptoms, colon polyps, or gastrointestinal disease requiring evaluation or treatment by colonoscopy (CPT Code: 45380 – See # 1 below).

When do you use modifier 59 vs XS?

The use of modifier 59 or XS indicates the service is a separate and distinct service from manipulation; however, the use of modifier XS would technically be more correct or accurate than 59. Make sure you are only using 59 or XS for massage and manual therapy; and only on the same visit as a CMT service.

What are 5 new codes that appear in CPT?

This is illustrated by the creation of five new CPT codes (98975, 98976, 98977, 98980, 98981) to report therapeutic remote monitoring, an increasingly important avenue of patient care especially during the COVID-19 pandemic.

How do I find my primary CPT code?

Often, a parenthetical note will identify the primary code(s) with which the add-on code must be reported. For example, following 10004 in the CPT® codebook is a parenthetical instruction “Use 10004 in conjunction with 10021.” On other occasions, however, the codebook doesn’t provide the primary procedure code(s).

What is the difference between 45378 and 45380?

A family of CPT codes applies to colonoscopy. 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.)

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.