Wiki Colonoscopy -know this has probably

[torihamill]

I know this has probably come up several times, but here goes again.
A pt came in Aug 2011 for colon w/biopsy 45380 at the age of 62 with UHC insurance and dx for diverticulitis. In 2008 he also had 45385 with UHC for dx blood in stool.
He is now 67 and has Medicare and has no symptoms. The client wants to bill for a routine colon to Medicare. He has not had any routine screenings within 10 years.

Can we bill a routine colon for this ptnt?

Thanks.

 

[ahansen]

I would use G0105 screening colonoscopy for Medicare with Z87.19 history of digestive disease for the dx.

 

[afalcon@dhcla.com]

i would use G0121 with z12.11 if there is no other family or personal history of cancer/polyps

 

[pamsbill]

If he had a 45385 that means he had a polyp. Therefore the correct diagnosis is Z86.010 and the CPT would be a G0105 unless something was found during this colonoscopy.