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You should not go for 45385 (Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor[s], polyp[s], or other lesion[s] by snare technique) as correct coding initiative edits bundle this code into 45383. The relative value units for 45385 (15.69 relative value units for non-facility) are lower than that for 45383 (16.72 relative value units for nonfacility); as such using the latter code will bring you more reimbursement: $568.09 (relative value units) multiplied by 2011 conversion factor of 33.9764). In this situation, you cannot unbundle the edit by using modifier 59 since interventions are on the same polyp. You'd bill the tattooing with 45381.
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