Gastroenterology Coding Alert

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.