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Gastroenterology Coding Alert

You Be the Coder:

Beat the Screening Vs Diagnostic Colonoscopy Dilemma

Published on Mon Mar 05, 2012

Question: A patient came to our gastroenterologist for a screening colonoscopy. During the visit, she said that she has been having abdominal pain for the past one year. Our gastroenterologist in the note says that the pain might be due to ovarian cysts. He recommended a fiber regimen and notes the screening colonoscopy. The patient underwent the colonoscopy. I would like to know whether to bill the colonoscopy as screening or diagnostic. Minnesota Subscriber Answer: To be clear about whether to bill the procedure as a diagnostic colonoscopy or a screening colonoscopy, you need to be clear about why your gastroenterologist asked for the procedure. If your gastroenterologist asked for the colonoscopy to ascertain and evaluate what the reason for the abdominal pain was, then you cannot bill the colonoscopy as screening. This is so because your gastroenterologist is checking the cause for the symptoms that the patient has been [...]
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