• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

personal hx of polyps vs hemorrhoids

K

kerileigh

Networker
Messages
70
Location
Dyer, TN
patient was to have a high risk screening colon for personal history, during the procedure there where no polyps or masses found. However the patient had a small hemorrhoid and the dr documented that he saw the hemorrhoid. The dr did not treat the hemorrhoid just documented that it was there. Would we change this to a 45378 with 455.0, v12.72????
 
The v12.72 would come first being the indication for the procedure, then you would list any additional findings during the procedure. Is your question regarding the Dx of the CPT codes? Dx would list your indication first followed by any procedureal findings, the CPT/HCPCS code is going to be carrier specific based on your ccontracts.
 
my question was regarding the cpt would we change it from g0105 to the 45378. the ins co reconginzies the g0105 with 100% benefits.

g0105-v1272,4550
45378-4550,v1272
 
If the patient has Medicare then you would keep this as G0105. If this is a commercial payer it should be 45378 unless your facility has a different agreement with certain medicare replacement plans. If the patient has a commercial payer you might want to throw a V76.51 at the beginning for a screening per past audits. Some coders will say you don't need it, but that's a point argued both ways many times.

Bob
 
You must log in or register to reply here.
Top