Wiki Colonoscopy w/ Poor Prep

[alewis]

I need coding insight with proof/reference, not opinion. Would you code a colonoscopy 45378, with scope getting through to the cecum with documented normal findings of cecum but throughout the transverse, descending, both flexures, the endoscopist was able to pass through but unable to visualize these parts due to poor prep (pasty, fecal matter) present? In my experience, colonoscopy coding depends on how far you get, not what you can or cannot visualize. Although modifier -52 Reduced Service was suggested by a superior due to the inability to visualize certain parts of the colon, it does not take away from the fact that the endoscopist was able to: get through the entire colon and document findings on the part that was visualized. Please help!!!!!!

 

[tpontillo]

Im not sure if this helps with your question:

http://www.supercoder.com/coding-ne...mbursement-for-incomplete-endoscopies-article

 

[EricaR]

http://www.gastro.org/practice/coding/coding-faqs-screening-colonoscopy

Your answer depends on what the Dr. is planning to do next. If he plans to repeat the scope you need to append a 53. If he is going to say do a barium enema there is no need to add any modifier as he did perform a "complete" colonoscopy. Please see the link. Everything in their info comes from CMS and you should be able to see the references. Hope thats helpful.