Wiki Chg for Office Visit before colon screen

[lisner1204]

I have a physician who states that I can bill an office visit (new patient) if the patient has come in for a visit prior to their screening colonoscopy and in the exam he finds GERD. He says since it is a dx in a different part of the system, I should code a NP office visit and use dx GERD first and V76.51 second. Is he correct?

If a patient comes in for nothing but a pre-screening visit for a screening colonoscopy with no other symptoms/GI problems or GI history, then we are not supposed to charge for the office visit, correct? I am new to the practice and I have suggested a 99499 Pre-screening, no charge code for the EMR billing. What does your practice do? I am new to GI coding.

Thanks.

 

[mitchellde]

Medicare has stated that if the patient is scheduled for a screening colonoscopy then there is no pre op encounter that can be charged, the fact that the patient meets the criteria for the screening has already been determined prior to scehduling so there is no medical necessity for a pre encounter. Also when you use the V code for the screening then a screening procedure must be linked to that V code. You cannot use a non complaint finding as a reason for screening an asymptomatic patient.
If your physician feels he should see the patient prior then it is ok, but you cannot charge for an evaluation the patient has already had.