Wiki Procedure cancelled due to incomplete prep

[AR2728]

Our general surgeon wants to bill an E&M for a patient scheduled for a colonoscopy, however, due to incomplete prep the colonoscopy had to be rescheduled. He documented a note stating the patients current labs, enemas given but not cleared, the contributing factors that may have interfered with the patients ability to only get down 3/4 prep, and then the options that the patient had for proceeding with prep in the hospital setting, rescheduling, etc. He documents he spent 15 minutes counseling the patient on options. He wants to bill an E&M based on that time. My concern is that this is preoperative work-up and will be considered an intregal part of the colonoscopy-since preop workup is included and the counseling was in regards to said procedure.

Would appreciate feedback on this one...

 

[DRBasel1045]

We dont ever bill and E/M with incomplete Colonoscopy due to bad prep/incomplete prep. was the patient already under anestethia? that is usually how we find out it was a bad prep, we bill out the 45378 w/53 modifier for physcian and 45378 w/74 modifier for facility (we bill both here) and add dx code V46.3. I was under the understanding that w/ and E/M code it had to be for a different problem then what the procedure was for but I could be wrong. Hope that helps..

 

[AR2728]

That's my understanding as well. Anesthesia had not yet been administered on this patient, he presented an informed them immediately that he had not completed his prep. Thanks for your input!