Wiki History of Polyps - Need some input please

[ENDOCODER]

Need some input please; If a patient comes in for a colonoscopy, non-Medicare, with a history of polyps (tubular adenomas)last colonoscopy over 10 years ago, is this an average risk colon screening or a surveillance colon? Is there any where that states if a patient has not had a colon in over x amount of years but has a history of polyps you can code this as an avg. risk colon, or once you have polyps no matter how long since your last colon it will always be a surveillance colon. Would appreciate anybody's thoughts on this.

 

[Colliemom]

I would bill it as a surveillance colonoscopy. Even though the procedure should have been performed around 3 - 5 years after the first one, the reason it is being done now is not screening but surveillance because of the personal history of polyps.

 

[ENDOCODER]

Thanks for your input, but now another question...Why is it that Medicare allows for a screening if you have a history of polyps every 24 months but if you had Blue Cross or Aetna or some other commercial insurance we bill as a surveillance? Just wondering. Would really like some thoughts.... and maybe another article from AAPC regarding this never ending subject.