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Thread: Correct order of icd-9s

  1. #1

    Default Correct order of icd-9s

    AAPC: Back to School
    If a patient presents for a colonoscopy and the indications are:
    Family history of colonic polyps (V18.51) & Abdominal pain;unspecified site (789.00) shouldnt the correct order of the icd-9s be 789.00 , V18.51?? The procedure ended up being a biopsy (45380) . The patient is telling us that we billed this wrong because her insurance paid the claim with a ded/coins because it is not being processed as preventative due to the 789.00 icd-9. We bill for an ASC- I am now finding out that the professional office billed with the V18.51 as the primary DX??? Could someone please clarify the proper order of icd-9 codes. Thank you very much.

  2. #2


    If the reason for the visit is specifically for screening you code the screening code followed by the family history, etc.

    If the colonoscopy is performed because the patient has a sign or symptom, the sign or symptom code is used to explain the reason for the test, not the screening code. However, if positive findings are discovered during the diagnostic colonoscopy assign the code for these findings instead.
    Julianne Sheetz, CPC

  3. #3


    Thanks for your reply. according to the operative report the indications were listed as both family history and the abdominal pain. I understand that a screening would come first if there were no symptoms. I am just trying to make sure that we are billing the same as the professional office but do not necessarily agree with how they ordered the icd-9 codes.

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