tci General Surgery Coding Alert - 2014 Issue 2

You Be the Coder: Employ These Tools for High-Risk Screening

Question: We had a patient who underwent a “high risk” colonoscopy screening for personal history of colon cancer. The surgeon found no abnormalities and took no biopsies during the procedure, so we billed 45378 with the ordering diagnosis V10.05. However, this payer will only recognize V76.51 for screening colonoscopy, so the patient’s diagnostic benefits were applied, engendering large out-of-pocket expenses. How can we code this scenario to utilize the patient’s screening colonoscopy benefits? Utah Subscriber Answer: If you’re billing Medicare, you should report the procedure as a high risk screening with code G0105...

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