Link to CMS guideline for dx sequence?

writecode

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Would anyone have a link to the most recent guideline from CMS on the sequencing of diagnosis for screening vs diagnostic colonoscopy? We have a grid with examples and are not sure if there has been a recent update to this?
 

Lisa Bledsoe

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I don't have a link, but I do know that if the scope is scheduled as screening (G0121/V76.51) and ends up with a polypectomy (45385/211.3); dx 1 should be V76.41; dx 2 should be 211.3 and ONLY DX 2 should be linked to 45385. Dx 1 (V76.41) still has to appear on the claim in the diagnosis field, just not linked to the procedure... does that make sense?
 

writecode

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Thanks for your help Lisa.
Unless we find other more current information from CMS, we will continue as before with coding the screening diagnosis as primary if the colonoscopy was ordered and scheduled as a screening. Then the diagnosis listed as secondary if any pathology is found during the exam.
 
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