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personal hx of polyps vs hemorrhoids

  1. #1
    Default personal hx of polyps vs hemorrhoids
    Medical Coding Books
    patient was to have a high risk screening colon for personal history, during the procedure there where no polyps or masses found. However the patient had a small hemorrhoid and the dr documented that he saw the hemorrhoid. The dr did not treat the hemorrhoid just documented that it was there. Would we change this to a 45378 with 455.0, v12.72????

  2. #2
    Mesa Arizona
    The v12.72 would come first being the indication for the procedure, then you would list any additional findings during the procedure. Is your question regarding the Dx of the CPT codes? Dx would list your indication first followed by any procedureal findings, the CPT/HCPCS code is going to be carrier specific based on your ccontracts.

  3. #3
    my question was regarding the cpt would we change it from g0105 to the 45378. the ins co reconginzies the g0105 with 100% benefits.


  4. Default
    If the patient has Medicare then you would keep this as G0105. If this is a commercial payer it should be 45378 unless your facility has a different agreement with certain medicare replacement plans. If the patient has a commercial payer you might want to throw a V76.51 at the beginning for a screening per past audits. Some coders will say you don't need it, but that's a point argued both ways many times.


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