LadyJ317
Guest
We are having a disagreement about how a certain colonoscopy should be billed. The patient had a screening colonoscopy in Feb. 2008 and it was billed as 45384 with Dx 211.3 and V16.0. Then the patient was seen again March 2011 and it was billed as 45378 with
V12.72. The payer is Anthem. Of course the insurance applied it the patient's deductible and the patient called. After reading Anthem's policy. I felt it was billed wrong and that the patient qualified as a "high risk" patient and I feel it should be billed as G0105 with V12.7. I thought that a diagnostic procedure should be coded with a diagnostic diagnosis. Someone please tell me what the correct billing should be. If I am wrong I need to know and I need to understand why. I have added Anthem's policy.
http://www.anthem.com/medicalpolicies/guidelines/gl_pw_c119565.htm
Thanks!!!!
V12.72. The payer is Anthem. Of course the insurance applied it the patient's deductible and the patient called. After reading Anthem's policy. I felt it was billed wrong and that the patient qualified as a "high risk" patient and I feel it should be billed as G0105 with V12.7. I thought that a diagnostic procedure should be coded with a diagnostic diagnosis. Someone please tell me what the correct billing should be. If I am wrong I need to know and I need to understand why. I have added Anthem's policy.
http://www.anthem.com/medicalpolicies/guidelines/gl_pw_c119565.htm
Thanks!!!!