colonoscopy coding

  1. B

    Wiki Medicare Plan Denying Screening Colonoscopy

    Hello, I am stumped on some denials we've been getting recently when billing CPT 45378 for a screening colonoscopy. The claim I'm working right was billed with dx Z12.11 and CPT 45378 to a United Healthcare Medicare plan. We got that CPT with that dx authorized. They are denying for "medical...
  2. A

    Wiki Undigested Food in cecum

    When a provider notes undigested food found during colonoscopy or an EGD, what ICD code do you report? The undigested food is not why they were seen; it's just a colonoscopy screening. Food is not removed, just noted.
  3. D

    Wiki Same mass multiple techniques used Colonoscopy

    Hello I need help, I know if you code a colonoscopy and multiple techniques are used to remove DIFFERENT masses/polyps you code each technique and add mod 59 to the others of less value. BUT my question is what if its the SAME mass and they used 2 techniques to remove the same mass. Can you...
  4. S

    Wiki Colonoscopy billing

    Hello, We are experiencing a high volume of denials for our provider when billing 45380 & 45385 together. I am currently using modifier XS as well. Typically, we appeal these services, and denials are overturned & appeals are paid. Our appeals outline that the provider is accessing either...
  5. S

    Wiki Moderation Sedation during Colonoscopies and EGD's

    When coding Outpatient Colonoscopies and EGD's are we to also code the MAC separately (99152, 99153; in this instance)? The sedation is inclusive to the procedure, correct? The CPT description for the procedure(s) doesn't say to code the sedation separately and to my knowledge the sedation has...
  6. R

    Wiki Colonoscopy w/ Snare Biopsy - missing path

    When working a procedure where the documentation supports 45385 but the resulting lab sample is lost - is the procedure still coded snare biopsy? How does this effect dx?
  7. J

    Wiki using pathology report to code for Colonoscopies

    I believe that the best way to code colonoscopies with biopsies is to wait for the path report. my physicians feel that"waiting for the path report delays claim filing, doesnt help with reimbursement and adds undue work" and that i should just go ahead with the k63.5 dx anyone else in this...