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coding a screening colonoscopy done same day as a diagnostic egd

  1. Default coding a screening colonoscopy done same day as a diagnostic egd
    Medical Coding Books
    How do I code a screening colonoscopy done on the same day as a diagnostic colonoscopy? I've tried to read up on Humana site and others with no guidance. Having trouble getting paid for the diagnostic part?? Suggestions

  2. #2
    Location
    Columbia, MO
    Posts
    12,841
    Default
    you use the V code for the screening colonoscopy first listed and the code for the finding secondary. You code the appropriate CPT code for the diagnostic colonoscopy and link both dx codes to the procedure. Then you put the 33 modifier on the CPT code or if Medicare the PT modifier. You canot list the screening colonoscopy you can list only the diagnositic. The modifier shows that a screening study was performed with a diagnositic component.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    I'm confused, was a diagnostic EGD or Colonoscopy done?

    If a screening colonoscopy is done with a diagnostic EGD, then you can code the colonoscopy as a screening and if you do it all in one visit you should still use V76.51 as the primary dx. If it is a screening colonoscopy that turns diagnostic you should follow the PT/33 rules, although only a few insurances like to pay for 33.

    Bob

  4. Default OOPS! It was a screening cscope and a diagnostic EGD.
    I missed typed! screening colonoscopy at same time as diagnostic EGD

  5. #5
    Location
    Boise, Idaho
    Posts
    424
    Default
    put a -59 on your EGD

  6. #6
    Default
    You should not have to use a modifier on either code. What denial are you getting for the EGD?
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  7. #7
    Default
    All you need is the 59 modifier on the EGD

  8. Default
    She shouldn't need a 59 on the EGD. I believe a 59 is for codes that are in the same anatomic site (colon for instance) but not for the same defect (same polyp). Now there are of course specific rules for different procedures, but a colon procedure and an egd procedure do not qualify in that way. Since a colonoscopy and an EGD are different anatomic sites you shouldn't need a 59. I'm sorry to disagree Janelle, but I believe this to be correct.

    Bob

  9. Default screening colonoscopy and egd
    Bob is correct...

  10. #10
    Default
    You are correct Bob, i was wrong

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