Pathology/Lab Coding Alert

Question: Our pathologist examined a biopsy from a screening colonoscopy that the physician performed because the 37-year-old patient's uncle had been diagnosed with colorectal cancer. The pathologist diagnosed an adenomatous polyp. Is the correct ICD-9 code V16.0, and is this a high-risk screening (V76.51)?Nebraska SubscriberAnswer: No, you should not report V16.0 (Family history of malignant neoplasm of gastrointestinal tract) as the diagnosis in this case. Instead, you should report the pathologist's findings, which is 211.3 (Benign neoplasm of colon).To use V16.0, the patient should have a family history of first degree, which means that an immediate relative such as parents, siblings, or children (an uncle doesn't qualify). The pathologist wouldn't report this code in any event, because the pathologic findings provide the most specific diagnosis.High risk screening: The following list shows the criteria under which a person can become eligible for a screening colonoscopy by reporting V76.51 (Special screening for [...]