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colonoscopy dx question

  1. Default colonoscopy dx question
    Medical Coding Books
    Hello all and HAPPY NEW YEAR!

    patient hx of ulcerative colitis

    Finding: very mild left-sided colitis of the sigmoid colon.....does not state CHRONIC or ULCERATIVE....use dx 558.9 rather 556.5?
    CPT 45378

    Thanks!!!
    Jamie

  2. #2
    Location
    Columbia, MO
    Posts
    12,531
    Default
    Yes given what you have stated I would go with the 558.9.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Charlotte, NC
    Posts
    534
    Default
    I agree with you both on using the 558.9.

    You could also add V12.79 (history of digestive disease) for the hx of UC as a secondary dx.

    And to speak to what Deb had educated me on in an earlier post, is this a follow-up exam/procedure based on the hx of UC? So also possibly use a V67.xx code.

    Fred Langley

  4. Default
    thanks for the help!!!

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