A patient undergoes a routine colonoscopy and polypectomy during the same operative session by Provider X. When preparing the claim for this procedure, how should the medical assistant correctly bundle the charges?
Report both procedures separately without any modifiers, as each procedure is distinct and should be accounted for independently.
Report both the colonoscopy and polypectomy with Modifier -51 appended to the colonoscopy to indicate that multiple procedures were performed.
Report only the colonoscopy since it is the less intensive procedure and the associated RVUs will cover both the colonoscopy and polypectomy.
Report only the polypectomy as the colonoscopy is considered to be part of the same procedural service and is not reported separately.
The correct way to bundle the charges is to report only the polypectomy, as the colonoscopy is included in the Relative Value Units (RVUs) for the polypectomy when performed during the same operative session. Reporting both procedures separately in this scenario would constitute unbundling, which is incorrect as it leads to overcharging the patient or insurance provider. Modifier -51 is not necessary in this instance because the National Correct Coding Initiative (NCCI) guidelines specify that the lesser procedure (colonoscopy) is bundled into the more comprehensive procedure (polypectomy), making it inclusive.
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