Wiki colonoscopy pre op visit

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I am new to gasto coding and have a question. It is my understanding we cannot bill for the pre op visit for a colonoscopy if it is done within 24 hours as the pre op is part of the colonoscopy service. But help me with these scenarios. The patient goes to the family doc because they are age 50+ and want their screening, the family doc refers them to the surgeon who then evaluates and does exam on the patient and schedules them for a screening colonoscopy in 2 weeks. Can we bill for the exam done by the surgeon since the colonoscopy is not scheduled for a couple of weeks out?

Second scenario, the patient went to see the surgeon for rectal bleeding, surgeon decides to do a colonoscopy in 2 weeks, he did an exam and ran blood work to verify his diagnosis. Can we bill for the surgeons visit? Does it make any difference if the patient went to see his family doc first and the family doc referred him to the surgeon for evaluation?

Thanks for any help you can offer I am trying to figure out when I can and cannot bill
 
Yes we can. For the first scenario, the Pre -op visit for colonoscopy with the surgeon can be billed with a Z01.818 diagnosis code.

For the second scenario, we can use the rectal bleeding as the diagnosis for the office visit.
 
Pre-OP Consult

There is an Scode that SHOULD be used for these consults when a patient is asymptomatic S0285:Colonoscopy consultation performed prior to a screening colonoscopy procedure
That would have to be set up at your facility. Anybody using it?
Tricia D
 
You guys make your patients come in for a visit before scheduling a screening? The docs around here just schedule the procedure on referral from the primary. If it's your first time, then the first time you meet the surgeon is in the pre-op area. The only time a patient sees the surgeon beforehand is if they have symptoms.
 
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