Repeat Colonoscopy

LeaHarris

Networker
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49
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Please help refresh my brain! I have a Medicare patient who came in for a repeat colonoscopy 10 days after his screening colonoscopy due to post-polypectomy bleeding stemming from his original procedure. Can I bill for this? I believe the global period for G0121 (originally billed) is 0, so do I bill G0121 again with a modifier? What modifier?

Thanks for your help,

Lea
 
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Olympia, WA
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You are correct on the global time frame. However, if they are going back in again due to bleeding then the G code would not be correct. G codes are for screening only. If there is bleeding shouldn't that direct your choice of CPT and dx?
 

lcolborn

Networker
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If they are having a rectal bleeding and or GI bleed from the post removal of the polyp, then it is diagnostic, not screening and it will be modifier 78 if the same physician is doing the procedure.

Hope this helps~
 

LeaHarris

Networker
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Thank you so much for your thoughts. I looked up the rules with Modifier 78.
Modifier 78 Fact Sheet
Inappropriate Usage
On any procedure code that does not have global period of 0010 or 0090.
When surgery is unrelated to the original procedure.
On procedures performed in any place other than the operating room.​

I think I will try with the appropriate CPT code and no modifier. I really appreciate your responses and helping me think about the bigger picture!
 
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