Wiki colonoscopy - I need help with scopes

[Callieb]

I need help with scopes done 7 days apart. First scope he went all the way to the cecum but visualization was poor due to poor prep. He then did another one 7 days later and found polyps. This all began as a screening and the patient has private insurance.
So scope #2 45385-33, 45380-59 with dx 211.3, 569.0, v76.51.
scope #1 45378 with mod 52? and v76.51?
I have tried finding a dx for poor prep or visualization and can find nothing.

 

[m3isme@yahoo.com]

1) The first colon would be coded 45378, 53 on the cpt line with a 33,53 in the modifier field on the professional claim.
Dx order: V76.51, v64.1
Add a comment to the claim "poor bowel prep". (put "poor prep" info. on both the professional and facility claim)
2) The facility claim would also be 45348, 74 on cpt line with a 33,74 in the modifier field.
Dx order: V76.51, V64.1
(if the ins. is medicare or a medicare advantage plan use G0121 instead of the 45378 for the cpt code)

The second colon done 7 days later would be:
Professional: 45385 w/33 modifier
45380,2 w/59,33 modifier.
Dx order: V76.51, 211.3, 569.0
(you can also add a comment next to 45385 and the 45380 letting the ins. know what sites the biopsy was taken. And point to the correct dx code)
IE: 45385:Rectum-point to dx 569.0 and 45380: Hepatic Flexure-point to dx 211.3.

 

[Callieb]

thanks for the input. Had not thought about putting a note on there.