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Gastroenterology Coding Alert

Reader Questions:

Is Follow-Up Colonoscopy A Diagnostic Encounter?

Published on Thu May 05, 2011

Question: A patient comes in for a follow up colonoscopy. The indication is chronic colitis, and the last colonoscopy was completed in 2005. He currently doesn't have any symptoms and has never been on any medicines to control it. Should we bill this encounter as a screening or as a diagnostic procedure? What codes should we report? Oregon Subscriber Answer: There are several high risk indications for follow-up colonoscopy at intervals more frequent than the every ten year routine screening colonoscopy. Patients with forms of ulcerative colitis (556.0-556.9) and Crohn's Disease (555.0- 555.9) have an increased risk of developing colon cancer andmay need follow-up colonoscopy as often as every two years depending on prior findings and activity of the disease. This increased risk of cancer and polyps may be present even when the disease is inactive and does not require regular medication. Commercial carriers general consider colonoscopies performed for these [...]
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