Gastroenterology Coding Alert

Use appropriate modifiers to unbundle codes, when necessary.To assess a patient with rectal hemorrhage or pain, your gastroenterologist might opt for a proctosigmoidoscopy. Since this procedure is significantly similar to a more extensive sigmoidoscopy, you will have to know how to differentiate these two procedures for accurate coding or face denials to your claims.1. Ascertain Insertion Approach Since proctosigmoidoscopy involves examination of the most distal portions of the sigmoid colon and the rectum, your gastroenterologist has to perform this procedure by inserting the scope through the anus. This approach differs from upper endoscopy procedures where the scope is inserted through the mouth.For example, if the documentation reads, "Scope inserted anally," you can be rest assured that your gastroenterologist performed a lower gastrointestinal (GI) endoscopy and not an endoscopy of the upper GI tract.2. Check Scope Type The next step to differentiate between a proctosigmoidoscopy and a flexible sigmoidoscopy is to [...]