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[QUOTE="Rpace18, post: 515759, member: 500273"]
Yes, the DX code Z86.010 is used as the reason for the colonoscopy. I know most Aetna/UHC/Cigna and some BCBS don't consider personal HX of polyps to be... [ Read More ]
[QUOTE="bethb, post: 515752, member: 57120"]
Hi and thank you for your reply. I'm stuck at past history of polyps.. if a patient presents for a surveillance colonoscopy due to a past history of a po... [ Read More ]
How do you guys code if a Medicare patient is told to come back in 1 year as the doctor wants to recheck a specific area for regrowth? When I was trained in, I was told to only code that specific poly... [ Read More ]
I agree with all the advice above. Neither one is correct from a coding standpoint. I agree that according to the information/documentation provided, the coding is incorrect. The Isovue was being used... [ Read More ]
Nothing changed that I know of as far as the NCCI CMS modifier 25 definition. [URL]https://www.cms.gov/files/document/chapter1generalcorrectcodingpoliciesfinal11.pdf[/URL]
Revision Date (Medicare): 1/... [ Read More ]
From my past experience if the patient had [B]symptom [/B]to warrant a colonoscopy..put that as first dx. So let us say the patient had fecal abnormalities dx R19.5 or bleeding K92 dx, th... [ Read More ]
Screenings will always have Z12.11 as admit and primary dx. As such then your therapeutic procedures(45385, 45380) will need modifier PT added.
When two CPT'S are done there will be an edit 40 ... [ Read More ]
[QUOTE="email@example.com, post: 499902, member: 538794"]
I am also confused as what to be billing. BCBS insurance. Patient has history of polyps Z86.010 comes back in for surveillance dr. doesn't... [ Read More ]
I am also confused as what to be billing. BCBS insurance. Patient has history of polyps Z86.010 comes back in for surveillance dr. doesn't find anything.
Would Z12.11 with Z86.010 and an asa code of ... [ Read More ]
[QUOTE="LisaAlonso23, post: 499381, member: 220094"]
If it's UHC, you need to use Z86.010 followed by the polyp code (ie, K63.5, D12.0, D12.2, D12.3, etc). UHC does not consider a colonoscopy for pati... [ Read More ]
New codes may help providers get paid for emerging services and supplies. The Centers for Medicare 38 Medicaid Services CMS has posted the HCPCS Level II code set update for fourth quarter 2023 on its... [ Read More ]
Know when to bill for debridement separately from surgery. Debridement removes foreign material andor devitalized or contaminated tissue until healthy tissue is exposed. It essentially cleans up the a... [ Read More ]
70 coding changes are coming soon. The American Medical Association is scrapping almost all of the COVID19 vaccine administration and product CPT codes it has created over the last several years. In t... [ Read More ]
Uninsured program payments were made to providers for patients who had health insurance and for services unrelated to COVID19. In July 2023 the Office of Inspector General OIG released the results of ... [ Read More ]
The rules for coding EKGs may change depending on the treatment scenario. Patients who report to the emergency department ED for an electrocardiogram EKG or ECG can create a coding quandary. Namely ho... [ Read More ]