tci Outpatient Facility Coding Alert - 2017 Issue 5

You Be the Coder: Cancelled, Postponed, or Discontinued? How to Code an Incomplete Colonoscopy

Question: Our gastroenterologist performed a diagnostic colonoscopy under anesthesia but was unable to get past the rectum due to a tight surgical colorectal anastomosis. He discontinued the procedure. The physician suggested that the patient would need surgery to correct the anastomosis. He also mentioned inadequate preparation for the procedure. He then sent the patient to radiology for a barium enema examination. Can I bill the colonoscopy procedure that our gastroenterologist attempted? If so, should I use the modifier 52 or 53? Oklahoma Subscriber Answer: Since your gastroenterologist started out the procedure with the intention of performing a complete colon...

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