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Gastroenterology Coding Alert

Reader Questions:

V72.83 Is the ICD-9 Code of Choice for Pre-Colonoscopy Visit

Published on Tue Mar 08, 2011

Question: We get denials when we bill 99203 or 99204 with diagnosis code V76.51. The insurance says we can't bill a screening with these CPTs because they are medical. What is your advice?Colorado SubscriberAnswer: If it's a pre-colonoscopy visit, Medicare and some commercial carrier consider the service as included in the colonoscopy procedure and not medically necessary as a separately billable service. For the insurance carrier that does cover this service, you should bill as a pre-procedure visit and report V72.83 (Other specified preoperative examination) as the diagnosis.Tip: Report the service for what it is. You are not screening for colon cancer at the pre-procedure visit itself, which is not done until the patient actually has the colonoscopy.Warning: Be careful with Medicare. If there aren't other things going on with the patient, then a routine pre-colonoscopy visit is not a billable service. If the patient is asymptomatic and has no [...]
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