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  1. R

    Wiki Global Denial 44389 / 45330

    Trying to bill 44389 and 45330 for colon through stoma and rectum. The 45330 is being denied as global. Do we now need a modifier somewhere?
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    Wiki Screenings under 45 / Family History

    How would you bill for a first time colonoscopy where the patient is under 45 and has a strong family history of colon cancer in 1st degree relatives? My physician has coded 45378 - Z1211, K648, Z800 but I've always been told the Z-codes are not billable for under-45 yr olds. How would...
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    Wiki Positive Cologuard

    Just asking as one of my doctors pulled me up on this - that insurances are not allowing positive Cologuard tests to hinder the billing of a subsequent screening. As far as I was aware, +Cologuard made the next colonoscopy a diagnostic procedure. I keep seeing different things online - could...
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    Wiki Medicare screening v surveillence

    Does Medicare pay for a screening v surveillence colonoscopy differently? Surveillence may incur the 20% of the allowable, right? I have a physician was has coded screening but pt has history of polyps and physician is questioning why he has to change the diagnosis and how it impacts the patient.
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    Wiki Screening w/biopsy w/no findings

    Thank you, Dana. It was initially a screening and the physician took random biopsies based on what he saw during the procedure, making it therapeutic. We used 45380 (PT) Z1211, K648.
  6. R

    Wiki Screening w/biopsy w/no findings

    Medicare denied saying Z1211 was not on LCD for CPT 45380. Biopsies taken for evaluation of microscopic colitis.
  7. R

    Wiki Screening w/biopsy w/no findings

    Getting a Medicare denial for a screening with biopsy 45380 PT with no pathological findings. How do I rectify this? Add K63.89 as secondary diagnosis?
  8. R

    Wiki G0121

    Screenings under CPT G0121 - can this only be billed with Z1211 or can you include incidental findings? i.e. diverticulosis?
  9. R

    Wiki History of Polyps / Modifiers

    If Medicare and most commercial carriers consider History of Polyps as a screening, then should we be using PT/33 modifiers for those screening procedures that become therapeutic? i.e. a Medicare or BCBS pt who had polyps several years ago in their first colonoscopy has a procedure today and...
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