Wiki Pre Colonoscopy Visit

[nancyenos]

How are folks billing for a routine pre-colonoscopy visit? If the patient comes in and the HPI said "no complaints, signs or symptoms" here to plan routine colonoscopy (no personal or family history either).

Complete Review of Systems, Comprehensive exam, and no Medical Decision Making other than instructions on colon prep.

So, there is no History, Comprehensive Exam, no MDM and no diagnosis other than the V76.51.

There is no preventive code that applies, and I don't think 99201-99205 or 99211-999215 would be correct since it is not a "problem oriented" visit.

How are you billing this, and are you getting paid?

 

[mitchellde]

You cannot use the V76.51 because you have not performed the screening yet. If you use that code for the OV then when you bill the actual colonoscopy the payer will consider it as a second screening and the patient will owe the co pay. you have no diagnosis that is applicable for a pre exam for a scheduled screening test. This is why most carrier designate this visit as inclusive.