Wiki Please help with coding Colonoscopy & Admit

[Hopp]

Hey there - Just need a little help with the following.
My doc performed an outpt Colonoscopy. Pt went home
came back to hosp. was admitted and then had sx. -
So how do I code this. Colonoscopy - as an outpt.
Admit 99223-25 & 57 and then the Sx. Still trying to understand how to code everything. Any help would be
appreciated. TIA
Deb, CPC

 

[GuzmanS]

I would code the colonoscopy as outpatient, with the E/M - 25 modifier, and 57 for the other procedure.

In a case like this it may be helpful to write a narrative on the HCFA explaining that the patient was admitted after colonoscopy for another procedure. I would send chart notes with the original claim to back it up.


Serenity, CPC

 

[RGALVEZ]

I am assuming that an E&M was Not charge during the colonoscopy because it was planned. I would bill the Admit with Modifier 24 because of the global for the colonoscopy. DX is not relevant. The Admit would look like this: 99223-24-57. You would also add Modifier 58 or 78 to the Sx code depending on the Sx done in the hospital. Modifer 25 would not be correct because of the outpt Sx. Things just are not simple as they appear. Hope I didn't complicate things more.