dawnha1
Contributor
We are having issues in Florida with a patient coming in for a screening colonoscopy and during the procedure a biopsy is taken. Do you get payment for the screening or the biopsy?
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Wiki colonoscopy screenings with biopsy
- Thread starter dawnha1
- Start date
jgossett
Networker
the biopsy rules out the screening. Try 45380. Depends on what else was done.
jgossett
Networker
I'm sorry. Now that I've actually read your question....no. You will get paid only for the biopsy, not for the screening. Once the biopsy is done, it is not a screening.
mitchellde
True Blue
you use the ICD-10 code for screening first listed and any findings from the biopsy secondary. You then drop the screening Colonoscopy procedure code and bill the colonoscopy with biopsy code with a PT modifier if billing Medicare or a 33 modifier for Commercial payer.
Pam Warren
True Blue
I concur with Debra. First listed code would be screening colonoscopy. The 'trump' to the diagnostic code is old guidance.
Hello, I'm a new biller and my question is about what ICD to use in this case, The doctor reports "No ulcerations, No polyps, no diverticulosis noted. Biopsies were obtained from ascending colon, transverse colon, descending colon, sigmoid colon and rectum Using cold forceps biopsy and sent for pathology." It's screening, so should I use 45380 with Z12.11,,, any other Dx? for the random biopsies?