Greenpiper
Contributor
Help Please,
We are struggling with finding information regarding colonoscopy consults. We are aware CMS does not allow, however there is never any discussion around a consult not performed on the same day as the procedure. For example: Patients PCP deems it time for patient to have a colo screening so they refer them to one of our surgeons. Our surgeon then sees patient (asymptomatic), goes over prep instructions, gets signed consent and sends patient to schedule procedure. We are then getting a claim to code for colo consult with a level 4 (99214 w/dx Z12.11, Z86.010). Sometimes procedure is within the week, sometimes later i.e months. IS this appropriate to bill?Does it matter that procedure was not done on same day?
Any insight is greatly appreciated.
We are struggling with finding information regarding colonoscopy consults. We are aware CMS does not allow, however there is never any discussion around a consult not performed on the same day as the procedure. For example: Patients PCP deems it time for patient to have a colo screening so they refer them to one of our surgeons. Our surgeon then sees patient (asymptomatic), goes over prep instructions, gets signed consent and sends patient to schedule procedure. We are then getting a claim to code for colo consult with a level 4 (99214 w/dx Z12.11, Z86.010). Sometimes procedure is within the week, sometimes later i.e months. IS this appropriate to bill?Does it matter that procedure was not done on same day?
Any insight is greatly appreciated.