coderguy1939
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This is a Medicare patient with a preprocedure diagnoses of HX of colon perforation w/colostomy placement who has developed a entercutaneous fistula who is undergoing colonoscopy via colostomy to evaluate for possible inflammatory bowel disease. Patient also has elevated PTT so no biopsies were done. Post procedure DX was "normal colonoscopy". This was coded 44388 569.69, V44.3 455.0 and was denied by Medicare as not medically necessary. Additional DX codes of V12.79 and 790.92 could have been used. Can this be appealed with any success?