# Barium Enema After Incomplete Colonoscopy



## Melissa K (Jun 17, 2015)

Our office performs barium enemas after an incomplete colonoscopy. Our billing company is using diagnosis code V64.3, which makes sense for coding the colonoscopy itself, but not so much the BE. To me, anyway. 

The claims are being denied using this V64.3, but I'm having trouble coming up with a better diagnosis to use. Is this diagnosis appropriate? 

Any help with this is appreciated!


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## DiMuchow (Jun 17, 2015)

*Barium Enema after Incomplete colonoscopy*

To, me , the logical way to approach this would be to look at the reason the colonoscopy was being done in the first place. You need a medical necessity reason for the barium enema being utilized. What does the provider say?

Diane Muchow, CPC


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## Melissa K (Jun 19, 2015)

Therein lies the problem. The history almost always states "Incomplete Colonoscopy". My assumption is that the colonoscopy was a screening, but we can't go off of assumptions. If we are able to use the screening for colon cancer code, that would be much better. I'm thinking it would be a good idea to ask the referring physicians to include on the referral whether or not the colonoscopy was a screening.


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## mitchellde (Jun 19, 2015)

V64.3 is a secondary only dx code, and it is used on the claim for a canceled procedure not on a claim with a completed procedure.  So if you are performing a barium enema after a discontinued colonoscopy, not an incomplete,  you would never use this code on the BE claim, unless the BE was started and discontinued(and then the V64.3 would be secondary) The claim for the discontinued colonoscopy would have this dx code as a secondary code. 
For the BE you need a code for why it was medically indicated.


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## Melissa K (Jun 19, 2015)

Those were my thoughts exactly. It didn't make much sense to me to use the code they are using. I am going to look into having our staff instruct the referring doctors to be more specific in regards to screening/diagnostic when ordering these exams.

Thank you all for your input!


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## susiemc (Aug 7, 2015)

*Anesthesia code for Barium Enema*

The patient had a Barium Enema in Radiology under General Anesthesia. For CPT 74270, any ideas on the appropriate anesthesia crossover code?  

Thanks!


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