Wiki Order of DX codes

[lindam@caricures.com]

When billing for a screening colonoscopy, patient has a history of polyps, family history polyps and a polyps was snared at this colonoscopy.
I always list the Z12.11 first, then Z86.0100, Z83.719, D12.3. Should I be putting the D12.3 that was found at this particular colonoscopy higher in the list?

 

[swisssmizz]

It depends on the payer. Since this is a screening each payer has a different way they like the provider to inform them it was a screening. For example if this was Medicare you would not use Z12.11 and code the high risk diagnosis however your diagnosis for high risk personal history of polyps and family history of polyps are coded as unspecified. You will need to code a more specific code for your primary diagnosis ie personal history of polyps adenomatous/serrated Z86.0101, personal history of hyperplastic Z86.0102 or personal history of other colon polyps (tubular) Z86.0109. To determine if family history or personal history should be listed primary you would have to review the report and see which indication is listed as the primary reason. Dx A personal hx/fam hx depending on report, dx B personal hx/fam hx depending on report then dx C D12.3. Then the diagnosis on the claim line would list the findings diagnosis first so in your case D12.3 which would be diagnosis C then B, A. Hope that makes sense, lol.