Results 1 to 5 of 5

Colonoscopy 2 days in a row

  1. #1
    Location
    East Valley, Tempe AZ
    Posts
    44
    Default Colonoscopy 2 days in a row
    Exam Training Packages
    A physicain did a colonoscopy for screening purposes made it the cecum but prep was poor. He did a repeat colonoscopy the very next day, the scope was advanced to the ascending colon before the procedure was aborted. He does not specify why it was aborted.

    The physician is coding
    1st day 45380 dx 556.9
    2nd day 45378-58 same dx

    Should it be
    45380 556.9,V64.3
    45378-74 556.9

    Any help would be appreciated.
    Lora

  2. #2
    Default
    Quote Originally Posted by LORA CRAWFORD View Post
    A physicain did a colonoscopy for screening purposes made it the cecum but prep was poor. He did a repeat colonoscopy the very next day, the scope was advanced to the ascending colon before the procedure was aborted. He does not specify why it was aborted.

    The physician is coding
    1st day 45380 dx 556.9
    2nd day 45378-58 same dx

    Should it be
    45380 556.9,V64.3
    45378-74 556.9

    Any help would be appreciated.
    Lora

    yes, i agree with you. i would code it with the -74 since it was a poor prep and ins will pay it at 100% contracted rate. the -58 is more for staged procedure....which it really isnt!

  3. #3
    Location
    East Valley, Tempe AZ
    Posts
    44
    Default
    Thanks so very much. Lora

  4. #4
    Default
    According to what you wrote here, 1st day: procedure was done as screening and reach the cecum but poor prep. If this is the case, it is still a complete colonoscopy as the scope reached the cecum. If the surgeon took a biopsy, your code would be correct but I guess you should use a mod 52 for the poor prep as the procedure was not visualize normally. If there is no biopsy and just plain screening G0121 for low risk and G0105 if pt is high risk. For the 2nd day, since the patient came back and procedure was terminated mod 74 is right as the procedure was cancelled after administering anesthesia. If the procedure was not taken a specimen, it'll remain as G code with mod 74 or 45380 if speciment was taken. By the way, you should use V76.51 as your primary diagnosis as the procedure was intended for screening and the final dianosis would be 2ndary. If you did not use any modifier on the first day, your 2nd day may get denied since the first was already a complete colonoscopy.

    Hope this helps.
    Last edited by bench; 07-30-2009 at 06:39 PM.

  5. #5
    Default
    If the purpose of the 2nd day was already for diagnostic since the MD already found a diagnosis, 45378-74 is correct.

Similar Threads

  1. Screening Colonoscopy versus Surveillance Colonoscopy
    By wsoler in forum Gastroenterology
    Replies: 20
    Last Post: 06-16-2017, 12:41 PM
  2. Row carpectomy
    By raidaste in forum Orthopaedics
    Replies: 1
    Last Post: 04-18-2014, 07:41 AM
  3. Colonoscopy Coding - 2 different days
    By TKoehn in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 02-10-2014, 04:48 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.