Wiki PCP Referral for Colonoscopy

[urbach34@yahoo.com]

I am coding for a PCP that had a patient come in requesting a referral for a colonoscopy because she has a family history of colon polyps. Doctor billed a 99212, and I coded Z83.71. It came back denied because dx code is preventative. Any suggestions? I asked the office for the notes, and the patient did not have any signs or symptoms...simply has family history and wants a referral. Is my doc even able to bill for this?

 

[danskangel313]

I am coding for a PCP that had a patient come in requesting a referral for a colonoscopy because she has a family history of colon polyps. Doctor billed a 99212, and I coded Z83.71. It came back denied because dx code is preventative. Any suggestions? I asked the office for the notes, and the patient did not have any signs or symptoms...simply has family history and wants a referral. Is my doc even able to bill for this?

You can only bill 99212 if the patient presents with a CC. Without any problems to report, I don't see this as billable.