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Medicare pt screening colonoscopy scenerio

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    Medical Coding Books
    If the pre-operative indications/Diagnoses includes lower abdominal tenderness this would not be a screening colonoscopy--it would be diagnostic. I would be looking at 789.6x codes for abdominal tenderness and 562.10 as the findings. I'd check your LCD and determine if 789.6x supports medical necessity.

  2. #12
    Smile Well, still not absolutely clear but
    V12.72 and V16.0 support G0105. Since the doctor calls it a followup, that is what I should code it as with those two codes. Since nothing was found, I will use the G0105 with them. I don't feel I can call it a screening if it is not documented as such. (The interpretation of the word screening is all over the place also). If Medicare wants us to follow their rules it really should be spelled out clearly; otherwise, they will get a mishmosh of codes entered by conscientious coders trying to interpret their rules, which is not fair to the patient if some are denied! Thanks to all who tried to answer my question.

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