Wiki Aborted Colonoscopy

[anknight77]

In the 2015 CPT book, I was informed in multiple meetings that the "Colonoscopy Decision Tree" found right before the Sigmoidoscopy section was incorrect. I was told that when the colonoscopy didn't reach the splenic flexure, we were supposed to still bill the colonoscopy but with the appropriate modifier. Now in 2016 CPT, the "Decision Tree" is exactly the same as last year. Has anyone heard if this is correct, or do we follow the same rules as last year? Thanks so much!

 

[CodingKing]

This is one of those real world coding vs coding by the book. AMA, CMS and other payers don't always agree on code selection. Payer determines if it follows the book or another policy. Some payers want you to bill planned procedure with mod, others want you to code as far as you got.

 

[anknight77]

Thanks!