Wiki screening colon converted to open procedure

[MSPEAKM]

Please advise on the following situation: A patient underwent a screening colonoscopy for personal history of colonic polyps and family history of colon cancer. During the procedure there was an accidental laceration to the colon. A partial colectomy had to be performed.
The colonoscopy was coded as G0105-53, however medicare has denied this due to the place of service as now being inpatient instead of outpatient. My question is, should the colonoscopy have even been billed? Has anyone had this situation before?

 

[acbarnes]

If it was during the same session, you would not bill the colonoscopy. If the patient returned to the operating room later that day, then you could bill the colonoscopy with a modifier 78 according to Chapter 6, Digestive Diseases, Medicare Part B manual.

Anna Barnes, CPC, CEMC

 

[Kisalyn]

NCCI edits also address this. States if an endoscopic procedure fails and is converted to an open procedure at the same patient encounter, only the open procedure is reportable.