Wiki V12.72 for colonoscopies

anwalden

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I'm hoping I can get some input on what everyone else does with their surveillance colonoscopies that present with diagnosis V12.72.

If it's a clean 45378 with no other diagnosis found, do you code V76.51 in addition to V12.72?

Our surgeons' intentions are solely for surveillance, and with the health care reform law changes for insurance coverage on preventive colonoscopies, it's a sensitive issue. Any feedback would be wonderful! Thank You!
 
It depends on what the physician documents. If the physician only lists the personal history of colon polyps as an indication we only code V12.72. If he lists the history of polyps and 'routine screening', then we would add the V76.51 as a secondary diagnosis.
 
Colonoscopies

If the intent of the colonoscopy is for surveillance because of a history of polyps, then you code the surveillance followed by the history code. Now if new polyps are found, you drop the history code and code the new polyps.:)
 
colonscopies

I'm not at access to my notes because i am home now but we code the screening code 1st if that is what the procedure was initially for and if something is found after the test then you would code that. If you have a CPT assistant you can I beleive you can find it there but if you like I do have this info on my desktop and you can email at Margaret.Willingham@va.gov
 
I understand that once a screening colonoscopy is done and a polyp is found. You cannot use the screening code V 76.51 anymore since - a screening is looking for problems- you can use the screening coded until a polyp is found. You need to use the history V12.72 if the patient has had a polyp removed.
 
I understand that once a screening colonoscopy is done and a polyp is found. You cannot use the screening code V 76.51 anymore since - a screening is looking for problems- you can use the screening coded until a polyp is found. You need to use the history V12.72 if the patient has had a polyp removed.

If the procedure is for screening then the screening code is first listed regardless of the findings, you do not drop the screening code. A screening is not looking for problems a screening is looking for a completely clean patient. A screening is an asymptomatic patient, if a polyp is found the polyp is coded secondary to the screening.
If the surveillance is being performed due to a history of polyps then you should use a follow up V code followed by the V12.72. If it is a screening with a history of the code the screening first with the V12.72 second.
 
V76.51

Blue cross applied a deductible to a screening v76.51 should this not apply if it's a special screening? I called bx and they stated that because of health care reform the clm was processed correctly- any advise?
 
Continued issues with Surveillance Colonoscopies

I'm still having issues with phyicians who want our ASC to code V76.52 as the primary dx code for surveillance colonoscopies on patients with a history of colon polyps. We code the V12.52 as primary, as the reason the patient came in at this particular time is due to the previous history. Is anyone else having this issue? How are you dealing with it?
 
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