Wiki Colonoscopy screening to diagnostic

[scrawford1690@gmail.com]

Hi everyone,

I coded a screening colonoscopy to be diagnostic due to a finding of an anal fissure. I thought if anything is find during a colonoscopy screening to code the diagnostic code 45378 (if no polyp removed) with modifier 33/PT. Patient is calling stating this was a screening... Just wanted to make sure I was correct before informing the patient of this.

Thanks!

 

[OpenClaims]

Hi everyone,

I coded a screening colonoscopy to be diagnostic due to a finding of an anal fissure. I thought if anything is find during a colonoscopy screening to code the diagnostic code 45378 (if no polyp removed) with modifier 33/PT. Patient is calling stating this was a screening... Just wanted to make sure I was correct before informing the patient of this.

Thanks!

Was the colonoscopy originally a screening? Did the patient have any signs or symptoms or linked diagnoses to having the colonoscopy done, or was it purely a regular screening?

If it was purely a screening, then you code the screening whether there are findings are not. You wouldn't consider that diagnostic if prior to the colonoscopy the patient didn't have any signs or symptoms that the provider linked as a diagnosis to support the procedure.

 

[LisaAlonso23]

If a screening (45378) is performed with a finding, it's still a screening. If the screening results in a procedure performed (45380, 43585, 45355, etc), it's considered diagnostic.

If no procedure was performed outside of 45378, then this is a screening and the patient will have not financial responsibility.

If the screening turned diagnostic with a procedure performed (ie, biopsy, polyp removal, etc.), the patient will have a financial responsibility.

Did they treat the anal fissure?

 

[scrawford1690@gmail.com]

They didn't treat the anal fissure, but it was a finding. Patient did not have any diagnosis before the screening.

I coded the 45378 with a 33 modifier to indicate a finding. Is that incorrect? Does the 33 only apply if a procedure is performed for the finding?

 

[scrawford1690@gmail.com]

Was the colonoscopy originally a screening? Did the patient have any signs or symptoms or linked diagnoses to having the colonoscopy done, or was it purely a regular screening?

If it was purely a screening, then you code the screening whether there are findings are not. You wouldn't consider that diagnostic if prior to the colonoscopy the patient didn't have any signs or symptoms that the provider linked as a diagnosis to support the procedure.

It was a screening, the patient had no symptoms. During the colonoscopy they found an anal fissure. I added a modifier 33. The 33 indicates it's still a screening even though there are findings right? Sorry I'm so confused