Rvu
If the patient is coming to your office to have a colonoscopy you should bill ONLY the procedure.
Every procedure - even a colonoscopy - includes some RVU for the pre-procedural evaluation. You are ALREADY being paid for this eval of patient when you are paid for the procedure.
If the patient is coming to your office with a complaint (symptoms of bleeding, pain, constipation, whatever ...) and as a result of your evaluation of the patient you decide to perform an additional diagnositic test/procedure (like a colonoscopy), then you can code the office visit (new or established, as appropriate). And if you perform the diagnostic test the same day, you'd add a -25 modifier to the E/M (but since colonoscopy requires a day of prep, I can't see that happening).
Having the patient come in a day or two early for an "eval" when they called to schedule a screening colonoscopy does NOT equal a billable service.
Hope that helps.
F Tessa Bartels, CPC, CEMC