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Thread: Incomplete Colonoscopy

  1. #1
    Join Date
    Apr 2007
    Greenville, SC

    Default Incomplete Colonoscopy

    AAPC: Back to School
    I have always been instructed that if the endosocpe does not pass the splenic flexure, that you would not code for a colonoscopy, but for the sigmoidoscopy that was actually completed. The definition (and illustration) of 45378 and the description in the CDR confirms this.

    But now I am seeing different information stating that you still code for the colonoscopy, but use the 52 or 53 modifier for reduced or discontinued services.

    Which is correct? Can anyone point me to specific CMS guidelines?

  2. #2
    Join Date
    Apr 2007

    Smile Cms guidelines regarding incomplete colonoscopy

    Bill for the intended procedure.

    http://www.cms.hhs.gov/manuals/downloads/clm104c18.pdf PAGES 108=109.

    I also found this link from the coding institute: http://codinginstitute.com/articles/...ete_Guide.html

    Hope this helps!

    Last edited by mhcpc; 08-17-2009 at 12:48 PM. Reason: additional information

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