Medicare Screens

[ercoder65]

If a Medicare patient presents for a screening colonoscopy, and has a history of polyps/colon malignancy, do you still use V76.51 as primary diagnosis or one of the history codes as primary diagnosis? What if the patient was a Wellmark/BCBS subscriber? Do they prefer the V76.51 as primary and then the history code second? Thanks gang!



Rich

 

[helenadutoit@comcast.net]

You would use the high risk codes, e.g. V12.72 or V10.05. Medicare prefers the G0105 that indicates high risk screening.