tci General Surgery Coding Alert - 2021 Issue Q4

You Be the Coder: Avoid Patient Payment for Screening Colonoscopy

Question: Our surgeon performed a screening colonoscopy for a 65-year old Medicare patient, but during the procedure, they excised two polyps and submitted them for biopsy. How should I code the case? Mississippi Subscriber Answer: First, you need to use the screening ICD-10-CM code as the reason for the test: Z12.11 (Encounter for screening for malignant neoplasm of colon). The screening code indicates that you’re performing the colonoscopy in the absence of signs or symptoms (including history, such as history of colonic polyps). You should also be aware that Medicare has a frequency limit of once every...

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