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Family hx coding

  1. #1
    Default Family hx coding
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    If a patient has a screening colonoscopy done for a family hx of colon cancer and then returns 5 yr later for a repeat for the same reason (family hx) would it be considered diagnostic or screening?

  2. #2
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    v76.51 then v16.0. It's screening.

  3. #3
    Location
    Lauderdale Lakes
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    203
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    Use the V16.0. Insurance will deny V76.51 because this is a screening and it is allowed once every 10 years. V16.0 is high risk and pt is allowed screenings more often because of that dx. Depending on the insurance it can be 3-5 years.

  4. #4
    Location
    Mesa Arizona
    Posts
    57
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    Quote Originally Posted by rcclary View Post
    If a patient has a screening colonoscopy done for a family hx of colon cancer and then returns 5 yr later for a repeat for the same reason (family hx) would it be considered diagnostic or screening?
    It would be considered high risk screening. v76.51 and v16.0. any denails for the age can be easily solved with a simple appeal letter including screening recomendation quote for high risk from the ACS. Asymptomatic with no personal history, its always screening.

  5. Default
    Someone I work with has actually been audited on this issue and told when its medicare you do not need V76.51, but for any other insurance unless stated otherwise you should include V76.51. I'm not 100% saying that is correct, that's just what she was told when she was audited.

    Bob

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