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Colonoscopies & preparing for OIG

  1. Default Colonoscopies & preparing for OIG
    Medical Coding Books
    In preparation of OIG, we are trying to make sure we are clear on our colonoscopy billings. For Medeicare: If you begin a colonoscopy as a screening and the surgeon sees diverticulitis/osis, do you continue to bill the procedure as a screening colonoscopy G-code or do you switch to a diagnostic CPT? I found on the Medicare website to use the screening Dx as primary and the findings dx as secondary, but they really didn't state whether to keep the G-code or not.

    Also curious if anyone has any advice on when one of our General Practician doctors sends a patient to one of our Internist/Surgeons via Referral or Consult. Is there any time when we can bill the office visit that the Internist/Surgeon spends with the patient before the colonoscopy, or is it always bundled with the procedure?

  2. Default
    Surgical procedures have built-in to them a pre-service, intra-service and post-service. What do you believe your provider would be providing to the patient that would not fit into the -pre-service that might be considered as a separate identifiable E&M service?

  3. #3
    I code colonoscopies on a regular basis. If the doctor does a biopsy or a polypectomy then you'll need to switch to the diagnostic CPT code. Don't use the G codes for that. If he only performs a basic colonoscopy and doesn't do anything else than use the G codes.

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