Gastroenterology Coding Alert
Watch Out for Screening Versus Surveillance
Question: A 52-year-old patient came into our practice last year, and the gastroenterologist removed a huge polyp. The doctor requested that the patient come back after one year. He returned, and the colon was negative. Should I bill 45378/V12.72 or G0105/V12.72? Michigan Subscriber Answer: First of all, you can only report G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) every two years. If you try to report it again, you'll receive a denial. If your gastroenterologist decides he wants to look at the colon during the in-between year, you should consider this a "surveillance" service. You should therefore report 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]) and attach V12.72 (Personal history of certain other-diseases; diseases of digestive system; colonic polyps). Hint: Don't confuse "screening," which in this case occurs every two years, with "surveillance." Surveillance relates to a particular problem the doctor wants to review.
Gastroenterology Coding Alert
- Cure Your Colonoscopy Denials by Following CMS' Advice About Screening vs. Therapeutic
Guidance concerning what diagnosis codes you should report may surprise you If you're confused about [...] - Focus on Crohn's Disease:
Plot Your Crohn's Coding Course, From Dx to Treatment
Sorting out these office visits from the rest could be a saving grace You know [...] - Physicians and E/M Coding:
6 Tips Will Clean Up Your Doctor's HPI Documentation
Hint: Get others involved to deliver the best possible claim Helping your gastroenterologist become a [...] - You Be the Coder:
Cirrhosis Diagnosis
Question: A patient’s medical record reads, "Cirrhosis likely secondary to alcohol dependency complicated by varices [...] - Reader Questions:
Master Incomplete ERCP Modifier Usage
Question: I'm coding an ERCP, and the doctor made numerous attempts with the catheter tip [...] - Reader Questions:
Watch Out for Screening Versus Surveillance
Question: A 52-year-old patient came into our practice last year, and the gastroenterologist removed a [...] - Reader Questions:
Here's What to Charge for Telephone E/Ms
Question: Will Medicare cover the new telephone evaluation services (99441-99443) in 2008? California Subscriber Answer: [...] - Reader Questions:
Avoid Paybacks for Cloned Documentation
Question: I often use previous electronic medical record (EMR) charts with the same chief complaint [...] - Reader Questions:
If in Doubt, Code Presenting Symptoms
