In my experience, it doesn't matter if the patient has a prior gastro condition, they could have any # of conditions, but that doesn't override the need to have the colon cancer screening. If the doc says that it is a screening, then it should be coded as such. The patient's intent for coming in was that of a screening, and this is what the guidelines state makes it codeable as a screening. The findings are incidental, and if a polyp is removed, you can still code the screening dx V76.51 as the prime dx for most payers.
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