# Coding for poor prep colonoscopy



## slimmagnum (Jun 15, 2015)

GOOD MORNING!
WHEN BILLING CPT #45378 WITH A 52 MODIFIER DUE TO A POOR PREP COLONOSCOPY, IS IT APPROPRIATE TO USE DX V76.51 ONLY OR SHOULD I USE IT WITH V64.1- SHOULD I EVEN  USE V76.51 AT ALL? 
THANK YOU!!


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## Sage123 (Jun 15, 2015)

Hello,

I have a few questions with your questions.

What was the reason for the procedure? Surely it wasn't a poor prep.
Was it a screening colonoscopy, therapeutic, or diagnostic?
If this was a colonoscopy how far was the scope advanced?
I'm only trying to understand more so I can give you a better answer and or direction.
Remember there was Guidelines changes in 2015 for colonoscopy.
When scope does not pass proximal to the splenic flexure report the appropriate sigmoidoscopy code. 
When scope goes beyond the splenic flexure but not to the cecum/colon-small intestine anastomosis and is a diagnostic procedure only, report the appropriate diagnostic colonoscopy/colonoscopy through stoma code with modifier -53 or -74. 
When the scope goes beyond the splenic flexure but not to the cecum/colon-small intestine anastomosis and a therapeutic procedure is performed, report the appropriate colonoscopy/colonoscopy through stoma code with modifier -52.

Please let us know so we can help.


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