Gastroenterology Coding Alert

3 Mythbusters Clear Up Your Complicated Colonoscopy Claims

When a screening procedure turns diagnostic, beware of V76.51 pitfalls. You know your colonoscopy codes inside and out, but what if your gastroenterologist brings a patient in for a screening colonoscopy and finds a polyp -- do you know how to capture proper payment for screening-turned-diagnostic colonoscopies? If you can overcome three common coding myths about these conversion procedures, you'll be sure to pick the correct procedure and diagnosis codes every time. Myth 1: Always Use a G Code When Doc Mentions Screening Fact: You'll use G codes to report screening colonoscopies, but when the procedure turns diagnostic your coding changes, too. If your gastroenterologist performs a screening colonoscopy for a Medicare patient, choose between two G codes: G0121 (Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk) for an average-risk patient receiving a screening colonoscopy, or G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) for [...]
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