I disagree with the comment that this is the way that the insurance wants it. Coding screening (v7651) is the way to code a colonoscopy so that it will get paid and there is no conflict with them or the patient. When I code V1272 as primary I do not get denials. I get deductible issues or 80/20 payment. But they are not denials. But as a coder I cannot in good faith code a patient who has a history of colon polyps or colon cancer as screening. I have to code the reason they are having the procedure and that reason is history. What do you do when a patient has Medicare and they have a hx of colon polyps and it has been two years since their colo? If you code V7651 with G0121 it will get denied for frequency because that can only be used every 10 years. The proper way to code it is V1272 with G0105.
Obviously we should all just agree to disagree on this one! LOL! The life of a coder. Now my big question -what are we going to do when we have a patient who has Medicare secondary and their primary payer recognizes consult codes next year? Do we bill the consult code or not?
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