Is it appropriate to use any of the preventative evaluation and management codes like 99381 etc for a pre colonoscopy visit, when a patient presents with no symptoms at all and this all pertains to a screening colonoscopy based on the patients age?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Pre Colo visit and using preventative E&M
- Thread starter cas614
- Start date
Pam Warren
True Blue
I would not. The preventive codes are used to report annual preventive exams, not for a pre-procedural visit. These are meant to report comprehensive preventive and risk-reduction evaluations of the patient, not for single-system issues or situations. (read the code description guidelines....they are very helpful) Further, if you bill out the preventive exam, and then later your patient goes to the PCP for their annual well visit, it will be denied (or vice versa).
CodingKing
True Blue
If its just a visit for a colonoscopy, then no E&M it's standard pre-op (ie decision to perform has already been made). I did hear of some new codes for routine colonoscopy consult (cant remember the code) but don't know if they are covered by any payers yet.
Thank you for your great advice! One more thing, I know how my doctors will respond to that. They will say, but I have not actually decided to do the colonoscopy yet and that they have to do a complete exam and history to do the procedure, any advice on how to answer this?
Typically patients are seen by their PCP for a routine visit and then the PCP refers them to the GI dr for a screening colonoscopy. The records from the PCP should suffice for complete exam and history if it truly is just a routine screening without symptoms. The PCP may also indicate in the referral that the patient has a family history of CRC or another risk factor, but even if they don't, gathering just that piece of information does not justify an E/M visit prior.
HTH!