AHA Coding Clinic® for HCPCS - 2023 Issue 4; Ask the Editor

Surveillance/Screening Colonoscopy Through a Stoma

A patient with a personal history of rectal cancer and status post abdominoperineal resection presents for a colonoscopy for cancer surveillance. The colonoscopy was performed through the sigmoid stoma (colostomy). The colonoscope was introduced through the sigmoid colostomy and advanced to the cecum, identified by appendiceal orifice and ileocecal valve. The entire colon was examined and appeared normal with no specimens taken. The colonoscopy was performed without difficulty.What is the correct code for a surveillance/screening colonoscopy through a stoma for a non-Medicare and a Medicare patient? Is it appropriate to assign a code that specifically states “diagnostic” in the code descriptor? ...

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