Internal Medicine Coding Alert
Colonoscopy Diagnoses
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Question: The patient presented with rectal bleeding (569.3, Hemorrhage of rectum and anus), and the internist performed a colonoscopy. The doctor's impression was diverticulosis of colon, without mention of hemorrhage (562.10) and internal hemorrhoids (455.0). How should I report this? Connecticut Subscriber Answer: Remember that you should never list incidental findings as the primary diagnoses, according to the Medicare Carriers Manual (MCM), section 15021.1 C. In your case, the rectal bleeding (569.3) is the primary diagnosis. But the diverticulosis of colon (562.10) and internal hemorrhoids (455.0) are the incidentals. Therefore, you should list the ICD-9 codes in this order:
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