Wiki Moderate Sedation with Screening Colonoscopy getting CO4 denials

cmfinnyw

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We are getting many denials, from all payers, on moderate sedation codes. Is it appropriate to attach the same diagnosis to the moderate sedation, that is used as the primary diagnosis for the procedure? Is there a different diagnosis that should be used - instead, or in addition to?

Also, per the MedLearn matters MM10075, modifiers 33 and/or PT should be used on the moderate sedation codes if related to screening colonoscopy. Are there additional modifiers that should be included?

Any information is greatly appreciated - thank you!!
 
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