Wiki Does family history of pancreatic cancer indicate a high risk screening colonoscopy?

[roni8807]

My office often uses Z80.0 (Family history of malignant neoplasm of digestive organs) as the primary diagnosis for high risk screening colonoscopies. According to the alphabetic index and notes in the tabular list of the IDC-10-CM, family history of pancreatic cancer is included in Z80.0. The old patients account manager instructed the providers and coders that this means when a screening colonoscopy is ordered for a patient with a family history of pancreatic cancer it should be coded as a high risk screening (G0105). We have a new provider in our group that insists that a family history of pancreatic cancer does not make the colonoscopy a high risk screening. I cannot find any guidelines regarding family history of pancreatic cancer and screening colonoscopies. Does anyone know if it is appropriate or not to code a high risk screening?

 

[kmartinez]

Z80.0 for High risk

Per the Noridian Endoscopy Procedures and Calculations webinar that took place on January 2018, Family History Z80.0 is considered a High-risk criteria code. So I agree with your providers who say it is appropriate to bill as a High risk screening colonoscopy.

Kathy M. CPC