Are you asking me that?
If so here it is:
Also from pg 22 of the coding guidelines:
"A screening code may be a first listed code if the reason for the visit is specifically the screening exam."
So again, you can read this different ways too.
How can you show the procedure was supposed to be a screening but converted to diagnostic with a V12.72 w/o using the V76.51? Sure, some payors will process correctly but not enough do.
Also, on page 29 section IV, part A subsection 1 (outpatient surgery):
"code the reason for the surgery as the first listed diagnosis"
Well the reason for the surgery is screening colonoscopy. You cannot show that it is supposed to be a screening using 45378 (or other diagnostic codes) by using V12.72. That only states the pt has a history of polyps, it's a secondary dx to why the procedure is being done.
Put it this way, a pt comes in for a screening and you use 45378 but they have no history, what dx would you use? V76.51 (which does not specify asymptomatic or otherwise, it only states Screening for malignant neoplasm, colon).
Ok, now another pt comes in for a screening but has a history of polyps. 45378, V76.51 and V12.72.
Once again for the first pt I would use G0121 and the V76.51.
For the 2nd pt I wouls use G0105 and V12.72.
But that's because the reason for the procedure is noted in the CPT itself for the G codes. It is not noted in the 45378 or diagnostic codes thereafter.
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