• 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..

Colonoscopy Debate

T

TLowe17

New
Messages
9
Location
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

 
TLowe17 said:
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.
Click to expand...
Can you provide a link to where the AGA says this? This is news to me...
 
jodielonkoski said:
Here's the link! its on the 26th, some webinars are more helpful than others but I'm hoping this one addresses z09/z12 in depth. I have unlimited webinars through my works subscription so I'll try to remember and comment back here after its live so you don't waste $85 if it's not helpful

Click to expand...
Webinar did not specify anything on Z09 but did reiterate a history of polyps does not mean the pt is symptomatic and if the indication is a screening z12 should be primary
 
Oh - I read the original post wrong, I thought you were saying the AGA instructs us to use Z09 for surveillance colonoscopy.

We used to use Z86.010- primary, but lately the payers have been wanting Z12.11 primary with Z86.010- as a secondary, and of course any findings dx's.
 
You must log in or register to reply here.
Top