Screening vs diagnostic colonoscopy

[Teresamd]

Hello. I have a physician that does NOT document when a colonoscopy is screening. Screening is not mentioned anywhere in the chart. He only uses history of colon polyps as the preliminary diagnosis. Is it appropriate to automatically code this has a screening colonoscopy with Z12.11? Thanks so much!

 

[LisaAlonso23]

Hello. I have a physician that does NOT document when a colonoscopy is screening. Screening is not mentioned anywhere in the chart. He only uses history of colon polyps as the preliminary diagnosis. Is it appropriate to automatically code this has a screening colonoscopy with Z12.11? Thanks so much!

It actually depends on the insurance. Some insurance companies consider a colonoscopy for a history of colon polyps to be a screening, however others do not.

For insurance companies that consider a history of polyps a screening, you would use Z12.11, followed by either Z86.010x or K63.5 or D12.x + any other findings.

For insurance companies that do not consider a history of polyps a screening, you would use Z09, followed by either Z86.010x or K63.5 or D12.x + any other findings.