coderguy1939
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I code for an ASC facility and I would like some input on the following coding scenario.
Pre-op DX: Screening
Post-op DX: Cecal polyp removed by cold biopsy, diverticulosis, internal hemorrhoids
Doctor did a colonscopy to the cecum and removed a polyp by cold biopsy. I'm coding 45380
My question revolves around proper DX linkage. In ICD-9 under Section IV Diagnostic Coding & Reporting for Outpatient Services under O. Ambulatory Surgery it states that "if the postoperative diagnosis is known to be different from the preoperative diagnosis at the time the diagnosis is confirmed, select the postoperative diagnosis for coding since it is the most definitive". However, if the patient has screening benefits, if you use 211.3 as the first-listed DX the patient's insurance carrier will often make the patient responsible for deductibles and/or co-pays. Screening benifits are often paid at 100%. Should the DX codes be coded:
1)V76.51 2)211.3 3)562.10 4) 455.0 and then only link DX codes 2,3& 4 to 45380? I'd appreciate hearing about how others are handling 3rd party payers. Thanks.
Pre-op DX: Screening
Post-op DX: Cecal polyp removed by cold biopsy, diverticulosis, internal hemorrhoids
Doctor did a colonscopy to the cecum and removed a polyp by cold biopsy. I'm coding 45380
My question revolves around proper DX linkage. In ICD-9 under Section IV Diagnostic Coding & Reporting for Outpatient Services under O. Ambulatory Surgery it states that "if the postoperative diagnosis is known to be different from the preoperative diagnosis at the time the diagnosis is confirmed, select the postoperative diagnosis for coding since it is the most definitive". However, if the patient has screening benefits, if you use 211.3 as the first-listed DX the patient's insurance carrier will often make the patient responsible for deductibles and/or co-pays. Screening benifits are often paid at 100%. Should the DX codes be coded:
1)V76.51 2)211.3 3)562.10 4) 455.0 and then only link DX codes 2,3& 4 to 45380? I'd appreciate hearing about how others are handling 3rd party payers. Thanks.