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Colonoscopy Procedure Coding

  1. #1
    Question Colonoscopy Procedure Coding
    Medical Coding Books
    If a patient is seen originally for a screening colonoscopy (V76.51) and during the procedure the only problem the physician encounters is diverticulosis 562.10 would this remain a screening procedure for Medicare or would the procedure change to 45378?

  2. #2
    Default
    You should code it as a screening colonoscopy and use the V76.51 code as the primary dx and the 562.10 as the secondary dx. If any biopsies, fulgration, or other procedures were performed, then bill for the cpt code with the v76.51 as primary and other dx as secondary.

  3. #3
    Default
    are there any signs or symptoms? usually with patient's who have diverticulitis, they experience abdominal pain, and/or diarrhea. So, if they have any of those signs or symptoms, it is no longer a screening scope, it is a diagnostic. hope that this helps.
    Malama pono,

    Sundae Yomes
    CPC, CPMA, CEMC, CGIC, CGSC, CCS-P

  4. #4
    Default screening
    yes, for Medicare you would use
    45378
    v76.51
    562.10

  5. #5
    Default
    A colorectal screening for a Medicare patient not meeting the criteria for high risk you would generally code as follows:

    G0121

    V76.51
    562.10

  6. Default
    Medicare patient w/ no "signs or symptoms" just a "screening"

    G0121 V76.51 prim and 562.10

  7. Default
    I agree with Coderguy
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS
    ciphermed@optonline.net

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