Wiki Hospital Clinic Visit

[Verna]

Our hospital has recently opened an oupatient clinic staffed by a general surgeon and an ENT surgeon. My question is this: when a patient comes in for a pre-produral visit for a screening colonoscopy, and has no complaints, what ICD-9 code do you use? Does the V70.0 code usually get paid, or is there another code that I'm unaware of?
I've been a hospital coder for years, but haven't coded clinic visits, so I'm just learning.
Thanks,
Verna

 

[Tarales]

screening for colonoscopy

Hi Verna,

The most common code would be V76.51-special screening for malignant neoplasms, colon.
If the screening is due to a family history of malignant neoplasms of the gastrointestinal tract V16.0 would be used and if there is a personal history of colonic polyps than V12.72 would be used. Check with the documentation and or the physician if unclear on the type of screening.

If a polyp or neoplasm is found there would be additional dx codes added to the screening codes. Hope that helps,

Tara

 

[mitchellde]

You would not use the screening code until the screening procedure is performed. There really is no dx code for this, you can try the V72.83 but it really is not a pre op visit. Or you can look at a V 68 for administrative encounter. Medicare has stated that this is a non billable encounter.

 

[reyesjr]

Verna, I absolutely agree with Tara on the code selection for screening colonoscopy based on the information you provided. V76.51
" According to ICD-9-CM Official Guidelines for Coding and Reporting, section 18.d.4:"

Janie Reyes CPC-A
Coder
Secretary SA Local AAPC Chapter