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Medicare Colonscopy question

  1. Default Medicare Colonscopy question
    Medical Coding Books
    Hello all,

    Pre OP dx: Ulcerative Colitis
    Post Op dx: normal colon. No evidence of colitis.

    In indiations states "hx of ulcerative colitis"

    Colonscopy was ok but did state " will start to wean him off his Asacol"

    Would this be 45378 and still use Dx 556.9 or G0105 w/ V dx?

    Thanks!
    Jamie

  2. #2
    Default colonoscopy
    Hello all,
    Pre OP dx: Ulcerative Colitis
    Post Op dx: normal colon. No evidence of colitis.
    In indiations states "hx of ulcerative colitis"
    Colonscopy was ok but did state " will start to wean him off his Asacol"
    Would this be 45378 and still use Dx 556.9 or G0105 w/ V dx?
    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    Good morning ---

    If this was a Colonscopy due to the colitis than yes I would use 556.9 and also use with the G0105 for high risk due to the history with V10.xx. If it was a screening than you would use the proper screening code V76.50. Just depending on what the whole documentation states. I hope that helps.

    Amy, CPC

  3. #3
    Default
    Medicare will cover G codes for screenings every 2 years. If the gastro decides he wants to look at the colon during the in-between year, you should consider this a surveillance service and report 45378. Also since there is not present evidence of colitis I would use V12.79. Hope this helps
    Last edited by bethh05; 07-13-2010 at 10:28 AM.

  4. Default
    Even though the patient does not have current ulcers or a "flare" they still have u/c if they have a colon (i.e. haven't had a colectomy) Ulcerative colitis is autoimmune and not "curable" except by removal of the colon and that would negate the need for a colonoscopy. U/C can be coded and should be coded as the primary dx because that is the reason for the colonoscopy. If its been 2 years since last colon you can use G0105. The other screening colon code G0121 is only allowed once every 10 years. Our local carrier will not process the 45378 with a v code so you would have to use the U/C code as the dx.

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