Wiki Diagnostic/Screening Colonoscopy

[NESmith]

I hate to beat a dead horse as the old saying goes, but I need some help. This pertains to commerical insurances. If a patient had a screening colonoscopy in 2003 not done by our GI doctors and a polyp was found and a colonoscopy polypectomy was billed with dx V76.51 and a colon polyp dx 211.3. In 2005 the patient came back and had another colonoscopy because they had hematochezia and hx of colon polyp but the colonoscopy showed internal/external hemorrhoids but other wise normal. Now the patient is returning for another colonoscopy with no symptoms but hx of colon polyp Can this be billed with dx V76.51 and V12.72 or is it only to be billed with V12.72. Pt's insurance is stating since it has been 7 years since a polpy was found that it can be billed as a screening. Is this correct? There is alot of disagreement between coders which is correct. Oh, also pt has family hx of colon cancer. Thank You for any help you can give.

 

[mitchellde]

It is still screening with the hx of polyp and family hx of colon ca. This is for screening purposes as the patient is asymptomatic. After 7 years it cannot be argued as a followup nor is it because of the polyp previously found. It is a screening as we expect nothing to be discovered.