Results 1 to 6 of 6

Surveillance colonoscopy vs screening

  1. Default Surveillance colonoscopy vs screening
    Exam Training Packages
    I am looking for guidelines outlining the difference between surveillance for previous hx of colon polyps versus screening colonoscopy. Also how are others coding this now? Thanks, Christine

  2. #2
    Default
    Since we are to code to the highest specificity I code a patient who has a history of colon polyps as V1272. They are not "screening" (V7651) in my opinion. It is important to use that diagnosis so that the insurance companies allow the the patient to have their colonoscopies sooner than someone who does not have a history. Using the V7651 so the patient can use their "screening" benefits is a diservice to the patient and also is not the correct way to code this pariticular scenerio in my opinion.
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  3. Default
    Do you code for the physician?

    Because I code for the facility that bills through a hospital, I cannot use V1272 as a principal dx; only as a secondary, so I would code V6709 followed by V1272. Do you get a lot of patient questions from this scenario? Do you know of any insurers who view it as screening over follow up?

    Thanks

  4. #4
    Default
    I do code for a physician.

    Medicare will view V1272 as "high risk" screening. There are some commericial payors but it depends on the patients policy. For example - some blue cross policies view it as screening and others dont. We do get some that question it because they want us to put screening so they can use their screening benefits. But once they hear that it helps them get their colos sooner they are usually OK with the situation. Of course you always have those view that you can never satisfy. LOL!
    Susie Corrado, CPC
    __________________
    ENT Coding/Billing

  5. Default
    Thanks!

  6. #6
    Default
    Under the Medicare guidelines for the high risk colonoscopies, the V1272 is only to be used for history of adenomatous polyps. If the patient only had hypperplastic polyps, V1272 is an incorrect code and this should be considered a screening colonoscopy (V7651), subject to the 10 year limitations. Unfortunately a lot of physicians either don't tell you what type of polyps the patient had previously, or they ablated them on the original and have no idea what they were.

Similar Threads

  1. Screening Colonoscopy versus Surveillance Colonoscopy
    By wsoler in forum Gastroenterology
    Replies: 20
    Last Post: 06-16-2017, 11:41 AM
  2. Surveillance or Screening Colonoscopy
    By dkrisak in forum Gastroenterology
    Replies: 4
    Last Post: 06-16-2017, 11:39 AM
  3. screening vs surveillance colonoscopy
    By katiejeanne in forum General Surgery
    Replies: 3
    Last Post: 04-05-2012, 02:23 PM
  4. Colonoscopy for screening or surveillance
    By Lisa Bledsoe in forum Gastroenterology
    Replies: 3
    Last Post: 12-09-2009, 05:25 AM
  5. Surveillance vs Screening colonoscopy
    By Deadpd in forum Gastroenterology
    Replies: 3
    Last Post: 01-02-2008, 06:31 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.