What are the main colonoscopy CPT codes frequently billed in GI, and what issues often cause denials?
Frequently billed colonoscopy codes include:
45378 – Diagnostic colonoscopy (no biopsy or intervention)
45380 – Colonoscopy with biopsy
45385 – Colonoscopy with snare removal of lesion/polyp
45390 – Colonoscopy with EMR (endoscopic mucosal resection)
45398 – Colonoscopy with band ligation
Common causes of denials:
Inadequate documentation of the technique used (e.g. snare vs other removal methods).
Misuse or missing modifiers (especially for screening vs diagnostic colonoscopies).
Incomplete operation notes, especially if the procedure morphed from diagnostic to therapeutic during the exam without clarity.
To know more - https://annexmed.com/gastroenterology-cpt-codes
