Wiki Colonoscopy with india ink marking of polyp

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lorrib

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Hi,

I have been struggling with a procedure performed by one of our surgeons and I am getting conflicting information and I am hoping someone can help. One of our general surgeons performed a colonoscopy for the purpose of marking a known polyp during a scheduled partial colectomy. The physician inserted the scope and reached the polyp which was just proximal to the hepatic flexure and used india ink to mark the polyp. The physician did not go any farther into the colon. The surgeon then proceeded with a laparscopic right hemicolectomy. Since the colonoscopy was utilized only in order to aid in the identification of the polyp during the hemicolectomy, I don't believe we can charge for this procedure. Is this correct or can we bill for the colonoscopy as a reduced procedure? Incidently, the poyp turned out to be an invasive adenocarcinoma (which was confirmed during surgery) which is why the surgeon converted the surgery ot a right hemicolectomy with primary anastomosis.

Any advice or assitance would be greatly appreciated.

Thank you,
lorri
 
a scount endoscopy is not billable



6. A ?scout? endoscopy to assess anatomic landmarks or assess extent of disease preceding another surgical procedure at the same patient encounter is not separately reportable. However, an endoscopic procedure for diagnostic purposes to decide whether a more extensive open procedure needs to be performed is separately reportable. In the latter situation, modifier 58 may be utilized to indicate that the diagnostic endoscopy and more extensive open procedure were staged



Chaoter 6 NCCI edit Medicare Policy Manual
 
scout colonoscopy

Hi,

I do believe the intent of the colonoscopy was to be able to identify the lesion/polyp for the partial colectomy since the surgery was already scheduled. After the colonoscopy, the patial colectomy was immediately started and the section of colon was biopsied. The surgeon waited for the path results and then based his decision on whether to keep the original surgery or convert it to the hemicolectomy with anstomosis.


Thank you so much for your help,
Lorri
 
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