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Wiki Visit Just To Order Screening Colonoscopy

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dballard2004

dballard2004

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I have a situation that is causing some confusion in one of my clinics that I would like opinions on, please....

A patient comes in to the GI office only because she has a family history of colon cancer and she wants the provider to order a screening colonoscopy. There is no other chief complaint. The provider performs an exam and then orders the procedure. The A/P just states "Screening colonoscopy, family hx of colon ca." The provider used code 99213 for this and I disagree.

Aren't codes 99202 - 99215 specifically for "problem-oriented" visits? Shouldn't there be a chief complaint here or is "family history of colon ca" considered a chief complaint? I personally feel that this should have been a preventive visit instead.

What are others thoughts and can anyone point me to specific guidance? Thanks so much.
 
You’re correct, 99202-99215 are visits for the evaluation and management of a patient problem, not for screening or preventive services for patients with no symptoms or complaints.

For the situation you describe above, I would recommend HCPCS code S0285.
 
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