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Colonoscopy Debate

T

TLowe17

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Newaygo, MI
I have seen previous guidance on here to bill G0105 along with Z12.11 for an asymptomatic patient that had a polyp removed previously and returns for a 5 year follow up. The AGA states that is incorrect and that z09 followed by Z8601x should be billed in these instances. Can you please provide Medicare source material that supports the useage of Z12.11 in this instance? The Medicare rep I spoke to only pointed me to Med Learn Matters articles that did not clear this up.
 
This isn't medicare specific but from AAPC stating to use Z12.11 over Z09. There's also a webinar coming up that hopefully addressed this. If the intent is a screening Z12 is correct and Z09 would be inappropriate. Z09 would be appropriate for a 6 month follow up to check polypectomy site, not for a screening on a pt who has history codes. The purpose of the procedure is a screening

 
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