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colonoscopy with history of polyps

  1. Question colonoscopy with history of polyps
    Medical Coding Books
    Pt comes in for a 5 year colonoscopy screening. He has a strong family history of colon cancer He had precancerous polyps removed the last time he had his colonoscopy(5 years ago). How would any of you code this. I've been told you would put a post op procedure code. I don't agree, he had them removed 5 years ago. History of polyps yes post op no. Please help

    I would code the screening for colon cancer primary, history of colon polyps secondary, and family history of colon cancer 3rd. Do any of you disagree, agree?

  2. #2
    Location
    Bradenton, Fl
    Posts
    82
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    Terry,
    I have to agree with your choices. Post-op shouldn't even be in the question...it was 5 years ago. In my opinion you are correct with the screening, hist polyp, and FH colon cancer.
    Angie Olson, CPC

  3. Default
    I agree with you and Terry.

    ~L
    CPC, CGSC, COSC

  4. Thumbs up
    Thank you both

  5. Default
    i agree 100%... vlm

  6. Default Colonoscopy with history of Polyps
    Hi,

    I would try coding:
    Admit:V67.09
    First Listed Dx (PDX): Depends. If new polyps are found and removed, code 211.3 colon polyps or 211.4 polyps are in rectum. If no findings, V67.09 will pass with V12.72.
    Seconday Dx: List any other findings (ex. colon diverticulosis, hemorrhoids).
    plus V12.72 (for hx of colon polyps) and V16.0 (if there's family hx of colon malignancy).
    Plus the appropriate colonoscopy procedure codes.

    Hope this helps.

    Maria

  7. #7
    Default
    According to Medicare guidelines, and alot of commercial plans to, your patient is still considered high risk, hence his five year interval. His personal hx of polyps would be first then his family hx.
    Kimm Hall CPC, CMSCS, CGCS

    If you live to regret then you have not learned lifes lessons.

  8. #8
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Quote Originally Posted by Terry CPC View Post
    Pt comes in for a 5 year colonoscopy screening. He has a strong family history of colon cancer He had precancerous polyps removed the last time he had his colonoscopy(5 years ago). How would any of you code this. I've been told you would put a post op procedure code. I don't agree, he had them removed 5 years ago. History of polyps yes post op no. Please help

    I would code the screening for colon cancer primary, history of colon polyps secondary, and family history of colon cancer 3rd. Do any of you disagree, agree?
    You are absolutely correct!

  9. Default colonoscopy w/ history of polyps
    Terry - you are correct in your coding with the screening code first, then the pt's personal hx of polyps, the fam hx of polyps. For Medicare patients, we do not use the "fam hx of" as they do not like it.

    LaSeille Willard, CPC

  10. Default
    Hmmmmmmmm, I was taught that if there is a history of colon polyps, that is your primary Dx, if nothing is found on the colonoscopy that is. If a polyp, etc. were found that would be primary. The reason for the colonoscopy is the history of polyps. For Medicare you would use G0105 for the screening code if nothing is found. Family history, V16.0 or V19.8, are also valid Dx's for G0105 for medicare. I only use V76.51 if nothing has ever been found, i.e. previous colonoscopies have been normal. Correct me if I am wrong, please.

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