|Home » Categories » CPT Surgery/APC Coding|
|Article Number: 465 | Rating: Unrated | Last Updated: Mon, Aug 1, 2011 11:44 PM|
What would be the diagnoses and procedure codes for the following scenerio: A physician refers a Medicare patient for a "surveillance" colonoscopy due to a prior history of colon polyps which were removed and the patient has no symptoms. The colon was clear and nothing was seen or removed with this "surveillance" colonoscopy.
While Medicare does not use the term surveillance in the context of a colonoscopy, the American College of Gastroenterology equates a surveillance colonoscopy with a screening exam. The term surveillance in ICD-9-CM indicates a condition that has been treated in the past and is no longer present but is being followed. This, in combination with the fact that a screening exam is defined as an exam in a seemingly well individual with no presenting symptoms would tend to lead the coder to code this as a screening exam of a high risk patient if the Medicare G codes are being applied. An appropriate V-code to capture the fact that the patient has a history of colon polyps will support the coding of the high-risk screening colonoscopy code. If necessary, develop an internal policy that addresses the coding of surveillance colonoscopies as screening and/or work with physician staff to more clearly delineate these as screening.
There are no attachments for this article.
Viewed 1818 times since Fri, Feb 11, 2011
Colonoscopy With Removal of Lesion
Viewed 4255 times since Tue, Nov 16, 2010
Transbronchial bx Modifier Issue
Viewed 3899 times since Tue, Jan 10, 2012
Fluoro & Injection to Check Port
Viewed 11802 times since Sat, Mar 19, 2011
Pinch Graft to Nose
Viewed 2205 times since Tue, Nov 16, 2010
Debridement of Bursa
Viewed 5972 times since Tue, Nov 16, 2010
Manual Reduction of Hernia
Viewed 6693 times since Thu, May 19, 2011
Viewed 191 times since Fri, Jun 24, 2011
Medical Nutrition Therapy
Viewed 2065 times since Thu, Dec 9, 2010
Viewed 2073 times since Fri, Aug 26, 2011