Question: A patient came in our office for a Buccal Colaris genetic test based on family hx of colon cancer. How do we code this scenario? Do we use a CPT® code for preventive care and if so which CPT® code. [...]
Hint: Do not use the modifier PT when the service began as a diagnostic procedure. Although the coding of a screening colonoscopy is a straightforward process and involves only a couple of relevant codes, problems arise when the same screening [...]
Question: Our physician performed a colonoscopy for a rectal bleed on a Medicare patient. The patient also has a family history of colon cancer. Should I report both 45378 and G0105? Kentucky Subscriber Answer: No, you should not report both 45378 (Colonoscopy, [...]
Question: A high-risk patient came in for a screening colonoscopy to our gastroenterologist. During the encounter, the GI noted that the patient also consulted the physician for an acid reflux problem. The GI then proceeded to ask questions about the patient’s [...]
Question: A high-risk patient came in for a screening colonoscopy to our gastroenterologist. During the initial encounter, the GI noted that the patient also consulted the physician for an acid reflux problem. The GI then proceeded to ask questions about [...]
Physical examination and physician decisions are key to correct coding. In the last issue of Oncology Coding Alert, Volume 16 Number 10, you read how history was elemental in E/M coding. Further steps to the right E/M codes include scrutinizing [...]
Order of codes presented in the claims makes a significant difference. Although Medicare covers a screening flexible sigmoidoscopy, it does not cover any other service provided during the procedure, whereas most non-Medicare payers are the exact opposite. Therein lies a [...]
Retain your V-codes even if the screening turns diagnostic. You should be following the rule that if your gastroenterologist performs colonoscopy screening on a patient, you must connect a “screening” diagnosis to the procedure, even if the physician discovers any [...]
See how one little modifier can help. If just thinking about colonoscopy coding gives you a headache because of all the convoluted coverage and billing rules, you’re not alone. But if you follow the logic of this one simple case, [...]
Question: I am looking for the diagnosis code for ‘Lynch Syndrome”, also known as ‘Hereditary nonpolyposis colorectal cancer’. I have looked this up in every possible way I can think of and can’t come up with the code. What is this [...]
