AAPC - Back to school
Results 1 to 3 of 3

Thread: Visit before Screening Colonoscopy

  1. #1

    Default Visit before Screening Colonoscopy

    AAPC: Back to School
    Please help with a patient of ours we referred to a general surgeon for a Screening colonoscopy. On our referrral form we also listed that the patient has a HX of breast cancer. Our local surgeon requires a visit before the actual procedure to take a history from the patient. Patient went to that visit, it was billed with 99203 with the diagnosis code of V76.51. Our patient has to pay the full price of the bill because medicare denied it. It seems to me that the billing is incorrect. Because the patient was referred there from our office is 99203 correct? Medicare is not going to pay the V code as primary in this case. Thank you for any help.

  2. #2

    Default screening colonoscopy and visit beforehand

    There must be clearly documented medical necessity in order to bill a visit prior to a screening colonoscopy. "Taking a history" is included in the procedure. There could be medical necessity to see the patient prior to a screening if the patient was a diabetic and they had to "adjust" their insulin. Or another scenario would be if the patient was on plavix, that would need to "adjusted or stopped" prior to the procedure. Other than for those scenarios, you shouldn't bill a visit prior to the procedure. Where is the justification for the visit. There nothing wrong with the patient, they are coming to the surgeon for a screening, not a problem or illness.

  3. #3

    Default Visit before Screening Colonoscopy

    Can someone provide me with a link to the publication within Medicare that states the pre op E/M is bundled with the procedure for G0121 or G0105 with dx V71.51? I know that when the E/M is performed on the day of the procedure it would not be allowed, however, I am unable to find documentation where the pre-op visit is not allowed performed prior to the procedure date. Neither code has a global period.
    Last edited by TEVANS68; 01-03-2011 at 01:20 PM. Reason: additional information

Similar Threads

  1. visit for screening colonoscopy no symptoms.
    By kbarron in forum Gastroenterology
    Replies: 4
    Last Post: 05-11-2016, 12:34 PM
  2. office visit prior to a screening colonoscopy
    By Tringenary in forum Gastroenterology
    Replies: 0
    Last Post: 01-16-2015, 07:34 AM
  3. E/M visit prior to screening colonoscopy
    By ashive7431 in forum E/M
    Replies: 2
    Last Post: 02-05-2014, 09:28 AM
  4. Pre screening colonoscopy visit
    By molisa in forum Gastroenterology
    Replies: 0
    Last Post: 08-18-2010, 08:12 AM
  5. Visit prior to a screening colonoscopy
    By BPinchbeck in forum Medicare Regulations
    Replies: 1
    Last Post: 04-16-2010, 10:42 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.