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Wiki "incomplete" colonoscopy due to poor prep

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kimberliterpstra

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The patient was scheduled 1/22/24 for a screening colonoscopy. The scope was advanced to the cecum, but the surgeon states this was "incomplete screening colonoscopy due to poor prep." The patient is already re-scheduled for another colonoscopy with a two-day prep on 2/5/24.

Do I code the 1/22/24 colonoscopy as screening and the 2/5/24 colonoscopy as diagnostic? I don't think I should use a modifier for the 1/22/24 procedure, because the surgeon reached the cecum, even though the surgeon states it was "incomplete"... he was not able to visualize any details because there was too much liquid stool due to poor prep.
I'm thinking the payor is not going to reimburse for two screening colonoscopies...
 
Hi! for the procedure on 01/22/2024, add a 53 modifier. Yes the physician reached the cecum but with 2024 guidelines, you can add a 53 modifier so when you bill for the 02/05/2024 procedure you can still bill it as a screening. Hope this helps!
 
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