Home » Categories » CPT Surgery/APC Coding

Surveillance Colonoscopy


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.

Disclaimer: All articles intended for general consumption only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.
Attachments Attachments
There are no attachments for this article.
Related Articles RSS Feed
Digital Nerve Block
Viewed 7636 times since Thu, Oct 27, 2011
TAP (Transverse abdominus plane) Nerve Block
Viewed 12223 times since Mon, Mar 21, 2011
Viewed 15454 times since Thu, Sep 8, 2011
CPT for Therapeutic Phlebotomy
Viewed 6110 times since Thu, Feb 9, 2012
Modifier PT and Medicare
Viewed 3693 times since Mon, Sep 19, 2011
Cysto with ESWL
Viewed 3746 times since Thu, May 26, 2011
Discontinued Colonoscopy
Viewed 2868 times since Thu, Dec 2, 2010
Excision Breast Tissue
Viewed 5658 times since Fri, Mar 25, 2011
Incomplete Colonoscopy
Viewed 4386 times since Thu, Oct 20, 2011
Injection for G Tube Placement
Viewed 7602 times since Wed, Jul 27, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506