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screening colonoscopy with symptoms

  1. #1
    Question screening colonoscopy with symptoms
    Medical Coding Books
    If patient presents for colonoscopy and is due for 5 year screening and presents with symptoms (bleeding) how are you sequencing the ICD-9 codes?

  2. #2
    Location
    Greeley, Colorado
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    2,045
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    Doesn't the bleeding render the colonoscopy as diagnostic now?

  3. #3
    Default
    If the patient comes in with a symptom I would code that first regardless of history.
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  4. #4
    Location
    Duluth, Minnesota
    Posts
    1,133
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    if the patient is coming in with symptoms (that's why they came in, bleeding) it would be a diagnostic colonscopy -
    Donna, CPC, CPC-H

  5. #5
    Default
    We have been coding them diagnositic but are wondering if the screening can be coded allong with the diagnostic code.

  6. #6
    Location
    Greeley, Colorado
    Posts
    2,045
    Angry
    I get this scenario a lot mainly because patients have screening benefits to where the procedure is not applied to their deductible. They want us to change the coding because they were due for a screening colonoscopy...but if it's done for a diagnositic reason (ie bleeding) it isn't screening. It becomes an issue with the insured and the payer and the policy they have. I get so frustrated with insurance companies telling patients that if we had coded their procedure as screening it would not have gone to the deductible. What no one else takes into consideration is that if it's not screening and they ask us to change it to screening, what they are asking us to do is FRAUDULENT.

  7. #7
    Default
    I agree!! Thank you so much for your help Lisa! It is much appreciated!!

  8. #8
    Location
    ENGLEWOOD/DENVER
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    2,338
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    ditto Lisa!!!! I've gone as far as calling back the customer service rep at the insurance company that gave the patient that info and asked them "What are you thinking?" Were you in the operating room?"...grrrr they drive me nuts and then patients get ticked off at us.

  9. #9
    Default
    I feel your pain Lisa! The line I get all the time from the patient is "my insurance said that you coded it wrong". I get so irritated !!!!!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  10. Default
    if the patient comes in for a screening and they find something you would list the vcode as your first dx and your findings second then on the procedure line you would show the 2nd dx first and the vcode second. showing the insurance this was set up as a screening that changed. example below

    DX
    1. v76.51
    2. 211.3

    CPT
    1.45380 211.3, v76.51

    hope this helps

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