|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 3147 times since Mon, May 14, 2012
Viewed 670 times since Thu, Oct 27, 2011
Holter Monitor / EKG Modifier 59
Viewed 1861 times since Fri, Oct 28, 2011
Viewed 799 times since Fri, Nov 2, 2012
Transbronchial bx Modifier Issue
Viewed 3559 times since Tue, Jan 10, 2012
Arterial Puncture Charge
Viewed 4572 times since Mon, May 28, 2012
Viewed 1670 times since Wed, Apr 6, 2011
Viewed 7220 times since Wed, Jun 15, 2011
Fluoroscopy in OR
Viewed 743 times since Mon, Nov 21, 2011
Bilateral Hip Injections
Viewed 988 times since Mon, Nov 19, 2012