Wiki Coding 45335 with 45331 with Modifier 53

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Hello, I need help with how to code for this OP note. The 2 cpt codes which are 45335 (Sigmoid flex inj) and 45331 (Sigmoid flex BX) but I need to know if I need to use modifier 53 and for what cpt code or for both? The OP note reads...
Several diverticula were seen in the distal descending colon and sigmoid colon
A circumferential mass with stigmata of recent bleeding of malignant appearance was found in the distal descending colon at 35 cm from the anus. The mass caused a partial obstruction. The scope could not traverse the lesion and the exam could not be finished. Multiple cold forceps biopsies were performed for histology. 5 ml spot injection was successfully applied for tattooing. Medium internal hemorrhoids were noted

Can I add modifier 53 since the exam could not be finished? and do I add the modifier 53 to both CPT codes?
Thank you in advance!
 
No modifier 53 required, looks like the physician intended a coloscopy to be done. So your just down coding it to the sigmoid codes, which wouldn't require the modifier 53.

Hope this helps.
 
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