I agree with coachlang3: for Medicare you code first the screening diagnosis and the findings second: please read the following:
(This is the way it was before) when the surgeon visualizes and biopsies the polyp, you should change the primary diagnosis from V76.51 (Special screening for malignant neoplasms; colon) to, for instance, 211.3 (Benign neoplasm of other parts of digestive system; colon), as outlined in the instructions CMS provided in February.
The retraction: Now, CMS officials are distancing themselves from their earlier instruction, pointing to language in the ICD-9 diagnosis coding guidelines that state that you should still use the screening diagnosis even if you find a problem during a screening exam.
"Should a condition be discovered during the screening, then the code for the condition may be assigned as an additional diagnosis," according to ICD-9 instructions.
Possible solution: Some experts have recommended listing the V code as the primary diagnosis in Box 21 of the claim form, but then including a "2" next to the procedure code in Box 24. This will let the carriers know that the secondary diagnosis, the polyp code, is the one that they should associate with the procedure code. Cobuzzi warns, however, that this won't work with most billing software.
hope this helps!!!