• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Aborted Screening Colonoscopy at Sigmoid

C

clarkmegan

Networker
Messages
64
Location
WILLIAMSBURG, VA
Given the CPT instructions to code a flex sig if the scope does not go past the splenic flexure, how are you all coding screening colonoscopies aborted prior to reaching the splenic flexure? My experience is if I were to bill 45378 with Z12.11 to Medicare for a completed scope, they would deny because they want G0121. So if a screening colonoscopy is aborted at the sigmoid colon, would you bill 45330 with Z12.11? Wouldn't that get denied by Medicare? Should we still report G0121-53/-74 even though it did not go past the splenic flexure? I can't find guidance regarding these types of scenarios...
 
Yes, bill the G0121 with the appropriate 53,74 modifiers. It is not a flex sig, it is an incomplete colonoscopy. You want Medicare to have that information on file for if the patient returns you can bill a complete colon.
 
You must log in or register to reply here.
Top