Wiki Coding a complete screening colonoscopy with suboptimal/poor prep

[Ging0609]

Would anyone be able to help me with a scenario where the provider clearly states he was able to reach the cecum during a screening colonoscopy and proceeds to take polyps from various parts of the colon, however, says the bowel prep is suboptimal and will have the patient return in 6 months for a repeat. In a Medicare patient, is this supposed to be billed with a -53 modifier? I am unable to find a cut and dry guideline from CMS on this.

Thanks in advance!

 

[trish4560@snet.net]

Yes, if they are returning due to poor prep, we will add Modifier 53