tci General Surgery Coding Alert - 2016 Issue 2

Reader Question: Don't Drop 'Z' Code for Screening Colonoscopy

Question: Our surgeon performed a screening colonoscopy for a Medicare patient, but found and treated a polyp during the procedure, which pathology later reported as benign. If we use the screening diagnosis code we don’t get paid — what should we do? Nebraska Subscriber Answer: Medicare has made it clear that if a patient presents for a screening colonoscopy, you must report a Z code such as Z12.11 (Encounter for screening for malignant neoplasm of colon) on the claim, even if the surgeon finds and treats other problems during the procedure. When the physician finds and treats...

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