tci Medicare Compliance & Reimbursement - 2008 Issue 6

Colonoscopies: Colonoscopy Procedure Code May Change, But The Dx Won't

Once a screening, always a screening, CMS says The Centers for Medicare & Medicaid Services (CMS) has clarified that if a physician finds a polyp or other abnormality during a screening colonoscopy, you should nevertheless cite the screening V-code diagnosis as primary. In fact, even if the physician removes the polyp, the exam remains a "screening" under ICD-9 guidelines. "This new CMS directive is a relief," says Heather Corcoran, coding manager at CGH Billing in Louisville, KY. "The issue of how to report a 'screening-turned-diagnostic' has confused a lot of practices, so a clarification was badly needed."...

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