Screening Colonoscopy - Patient with Blue Shield

coderguy1939

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Patient with Blue Shield insurance had a screening colonoscopy (no pre-operative symptoms) and polyps were found and removed by snare 45385. DX codes used were V76.51 and 211.3. BS denied because patient did not have screening coverage. Can 211.3 be used as primary code if the purpose of the procedure was screening?
 

saran21181

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Yes. 211.3 can be used as primary diagnosis. Screening colonoscopy does not fall under the diagnosis category.This status code used to indicate procedure was done.
 
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Hello,
During screening colonoscopy, no biopsy or removal should be done- only V code as primary diagnosis.
When a colonoscopy with removal of polyps by snare technique, has been done we can code 45385-211.3, minus the word screening.
 
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