screening colonoscopy

  1. letootz

    Wiki 45380-33 denying as frequency with 45385-59

    BCBS NC is denying the biopsy for max benefit, but the patient was seen for a colonoscopy screen that included the biopsy and polyp removal done on multiple sites. The biopsy was performed to confirm colon cancer, but I'm confused how they can both be billed out as they're both colonoscopies...
    • letootz
    • Thread
    • bluecrossblueshield north carolina screening colonoscopy
    • Replies: 3
    • Forum: Gastroenterology
  2. B

    Wiki Medicare Plan Denying Screening Colonoscopy

    Hello, I am stumped on some denials we've been getting recently when billing CPT 45378 for a screening colonoscopy. The claim I'm working right was billed with dx Z12.11 and CPT 45378 to a United Healthcare Medicare plan. We got that CPT with that dx authorized. They are denying for "medical...
  3. T

    Wiki Office Visit Colorectal Cancer Screening

    Hello! I bill for a Gastroenterology office and I always get confused about this. Patient came in for their office visit before their colon screening. Patient had a colon screen done 10 years ago. The colon screening paid in full like it should but the office visit applied to his deductible...
  4. X

    Wiki Modifier 33 on CPT 45378

    The following is a practice test question that I took recently: MEDICAL RECORD SEX: MALE AGE: 47 DOS: 1/1/20XX PHYSICIAN: PREOPERATIVE DIAGNOSIS: Family history of colon cancer and multiple colon polyps. POSTOPERATIVE DIAGNOSIS: Normal colon. OPERATIVE PROCEDURE: Screening Colonoscopy with...
  5. R

    Wiki Colonoscopy Screening - Medicare

    How would you code a colonoscopy screening for Medicare? Patient has personal hx of polyps and is coming in for surveillance. A coworker is telling me she codes as below. Do you agree? 45380 - PT Z12.11 Z86.010 K63.5 K57.30 PREOPERATIVE DIAGNOSIS: 1.History of colon polyps...
  6. N

    Wiki HPI in E/M Leveling

    When leveling a GI office visit where the reason for the visit is to plan a screening colonoscopy with no presenting problems, what information are we allowed to use under the HPI section of an E/M Leveling sheet? My team lead and I are trying to determine if we can use "location" since we know...
    • nicoleysmith
    • Thread
    • e/m leveling hpi screening colonoscopy
    • Replies: 5
    • Forum: E/M
  7. A

    Wiki Billing Screening Colonoscopy Work Up

    One of my providers is asking if he can bill a screening exam for a patient who ended up deciding not to have the colonoscopy performed. The patient did not present with any symptoms and was otherwise healthy, so the only diagnosis we have to bill is the Encounter For Screening Z12.11. I...
  8. R

    Wiki Screening colonoscopy via stoma

    Medicare patient has had a partial colectomy and creation of stoma for cancer. They now present for colon evaluation due to past history of colon cancer. Dr. performed procedure through stoma (44388). Does Medicare consider 44388 with Z85.038 (personal history of intestinal malignancy) a...
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