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Preop Ov for screening colonoscopy

  1. #1
    Default Preop Ov for screening colonoscopy
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    Hi everyone still kind of new to coding. I code for a general suregon. We recently saw a NEW Pt for OV. Pt needs a screening colonoscopy as prescreening for a kidney transplant. Pt has no symptoms. Dx for kidney transplant is Renal Failure. Pts insurance is BlueCross and Blue shield
    Does anyone know if I can code the office vist if so what codes would be used for DX
    TIA for any input.
    Deborah, CPC

  2. #2
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    Charlotte, NC
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    You can and should code the pre-op OV but you probably won't get pd for it as it is usuallly rolled into the cost of the procedure. I would get an ABN just to be safe or just eat the charge of the OV.

    I would probably use V76.51, though it's a tough one, along w/ the code ICD-9 dx for renal failure.

    Anyone else think this is a high risk screening instead? I'm on the fence here.

    Might also need to check on the benefits since some have a stipulation that once you use the dx (V76.51) you can't use it again within the set time limit.

  3. #3
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    We have done colonoscopies for people that need kidney transplants and in our cases the transplant center paid for the visit and the colo since it was required prior to the transplant. I would check with the transplant center to see if they are responsible for the bills. They actually told us that the dx should be v7285 when we billed our services. Hope this helps!
    Susie Corrado, CPC
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    ENT Coding/Billing

  4. #4
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    Quote Originally Posted by coachlang3 View Post
    You can and should code the pre-op OV but you probably won't get pd for it as it is usuallly rolled into the cost of the procedure. I would get an ABN just to be safe or just eat the charge of the OV.

    I would probably use V76.51, though it's a tough one, along w/ the code ICD-9 dx for renal failure.

    Anyone else think this is a high risk screening instead? I'm on the fence here.

    Might also need to check on the benefits since some have a stipulation that once you use the dx (V76.51) you can't use it again within the set time limit.


    I think that the only existing conditions that would count for a high-risk colonoscopy screening are family/personal history of colon cancer and/or polyps, ulcerative colitis, or Crohn's disease. This may only be the case for Medicare, but a lot of the insurance companies are following their guidelines for screenings now.
    Last edited by LTibbetts; 10-06-2009 at 10:17 AM.

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