Wiki Coding reducred service for asc

[ENDOCODER]

I'm hoping I can get an answer to this one.
A Medicare patient came in for an average screening colon. The patient had a polyp but the physician did not remove the polyp because patient was on Coumadin. His plan is to remove polyp at hospital in 5 days.
I am going to code the G0121, but is there a modifier I would use other than 74 for discontinued procedure? a reduced service code for the ASC?
Appreciate any help on this one.

 

[CodingKing]

No modifier needed, the full service reported by G0121 was completed. They just never got to the surgical part but you aren't billing for a surgical colonoscopy.

 

[ENDOCODER]

Thanks for answering. I was just thinking what happens when patient goes to hospital for the colonoscopy to have polyp removed. They wont be able to code for the average risk colon with polyp removal, can they?

 

[CodingKing]

When they go to the hospital its no longer routine and its just like any other colonoscopy due to symptomatic (thus cost share will apply). I'm not sure why they insurance wouldn't just have the patient get the original colonoscopy in the hospital due to the coumadin. Otherwise the original procedure was a waste of time and money since they could only look but not touch.

74 is for unforeseen complications that threaten the patients life, causing the discontinuation of the remainder of a procedure. They would have known from the start that they couldn't do anything but screening, so nothing was really discontinued.