First, your physician may not be able to bill for the obersvation E/M beacuse this is part of his pre-op for the colonoscopy, not a seperately identifiable E/M visit.
However, for diagnosis I would code the scrn code first and any additional codes that may explain why he cannot do the prep at home (e.g. paraplegic, alzheimers, etc). Medicare won't like it though and may have recommended nursing home or home health services to help with prep.
Anna Barnes, CPC, CEMC, CGSCS
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