What ICD 10 and CPT to use for post transplant patient for routine colonoscopy with Medicare?

patdow

Networker
Messages
25
Location
Kingwood, TX
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We have a post transplant patient who had a colonoscopy in 2016. We used Z12.11 and Medicare paid. Patient did not have any other dx findings on report. Our transplant patients need to have routine colonoscopies every 5 years. Medicare denied her recent claim with Z12.11 and G0121. What ICD 10 code and CPT code should I use to get Medicare to pay?
 

mconner001

Networker
Messages
42
Location
Olympia, Washington
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You don't mention the kind of transplant. Liver? Does Z85.05 apply? Have you looked at current LCDs? Noridian Medicare has an article A57343 that provides a list of appropriate diagnosis codes. Does your Medicare carrier have anything like it?
 

patdow

Networker
Messages
25
Location
Kingwood, TX
Best answers
0
You don't mention the kind of transplant. Liver? Does Z85.05 apply? Have you looked at current LCDs? Noridian Medicare has an article A57343 that provides a list of appropriate diagnosis codes. Does your Medicare carrier have anything like it?
The patient is post liver transplant. Z85.05 does not apply. I will look into the article. Thank you for the suggestion.
 
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