Enounter for screening codes

MarieL

Networker
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Woodruff, SC
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Could someone please clarify something. For the screening codes, for example Z12.11 encounter for screening for malignant neoplasm of colon. Is it alright to pick up this code for the ordering of a colonoscopy , or should this be only for the encounter of the colonoscopy? We have providers/coders picking this code up for whenever the provider is ordering the colonoscopy and also if the patient is in for a pre-op for the colonoscopy. If someone could clarify this , please do. THanks!
 

mitchellde

True Blue
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Columbia, MO
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The answer to your question is within the coding guidelines.
"The Z code indicates that a screening exam is planned. A procedure code is required to confirm that the screening was performed."
Therefore if you are not performing the screening procedure at that encounter, do not use the screening Z code.
 

adbakker23

New
Local Chapter Officer
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Lakeland, Florida
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Amanda

I am still learning Colonoscopy coding but here is what I would say. The Z12.11 is just for the procedure, but just be sure this is for a screening. If the patient presents with symptoms, it is not a screening but a diagnostic procedure. Also, when you use Z12.11, don't forget modifier PT for Medicare and 33 for non Medicare insurance and put Z12.11 as the primary DX. That tells insurance it is a screening colonoscopy. For pre-op office visits, you can use Z01.818 as the primary DX and put Z12.11 as the second but it is not necessary to put Z12.11. Hope that helps!
 
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