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screening colon , Need help!!!!

  1. #1
    Default screening colon , Need help!!!!
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    I work for the physician side and when doing a screening and during the procedure a polyp is found we code out for the polyp and still use the V-code on the claim but not as a pointer to the cpt. How should it be coded on the hospital side.

  2. #2
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    Lauderdale Lakes
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    For both physician and hospital, screening is primary and the polyp is secondary

  3. #3
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    thank you, thats what i thought , but the director says NO

  4. #4
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    Lauderdale Lakes
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    203
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    Just in case your director needs something in writing here is a link to an article about screening colons

    http://health-information.advanceweb...noscopies.aspx

  5. #5
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    If your billing Medicare, you code the polyp removal and add modifier PT. -PT mod. Tells Medicare that it was a screenimg turned diagnostic. If other insurance, you still code the polyp removal. From what I understand, if you remove a polyp, It's no longer a screening.

    Advance Magazine posted an article regarding this. Search colonoscopies.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

  6. #6
    Location
    Columbia, MO
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    12,570
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    Quote Originally Posted by drakena74 View Post
    If your billing Medicare, you code the polyp removal and add modifier PT. -PT mod. Tells Medicare that it was a screenimg turned diagnostic. If other insurance, you still code the polyp removal. From what I understand, if you remove a polyp, It's no longer a screening.

    Advance Magazine posted an article regarding this. Search colonoscopies.
    No it is stil screening even if you remove a polyp and the screening V code is still first listed, but as Medicare has the PT modifier, commercial has the 33 modifier to indicate a screening procedure with a diagnostic component.

    Debra A. Mitchell, MSPH, CPC-H

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