Fee Navigator®

    Health Service Code 57.13A

    Bipolar electrocoagulation/heater probe hemostasis or endoclip placement or argon plasma coagulation for bleeding lesions of the colon following an initial procedure at a separate encounter, additional benefit

    1. May only be claimed in addition to HSCs 01.16B, 01.16C, 01.22, 01.22A, 01.22B, 01.22C, 01.24B, 01.24BA and 01.24BB.
    2. May only be claimed in situations where the patient has post-polypectomy bleeding following an initial procedure and must undergo a repeat procedure to manage post-polypectomy bleeding.
    3. May not be claimed for services provided at the same encounter as the initial polypectomy.
    Common terms:
    • colonic clip
    Category:4 Major Procedure (pre-operative period: 7 days, post-operative period: 14 days)
    Base rate:$136.79

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$111.15

    Governing Rules:

    • 6.8.1

      HSCs with a designated category code of 1 and 15 include related post-operative services and those with a designated category code of 3, 4, 6 and 14 include both related pre-operative and post-operative services.

      1. a consultation benefit may be claimed up to and including the day of surgery.
      2. pre-operative hospital care may be claimed by the physician who performs the surgery if information is submitted to show that conservative treatment was attempted before surgery was performed.
      3. benefits may be claimed as applicable for complications occurring during or following post-operative time periods.
      4. Deleted
      5. HSC 03.04R may be claimed in the pre-operative time frame when all conditions in the notes have been met.

      The following chart gives the pre-operative and post-operative periods.

      10 - Days14 - Days
      37 - Days7 - Days
      47 - Days14 - Days
      614 - Days14 - Days
      1430 - Days14 - Days
      150 - Days7 - Days