Wiki Screening colonoscopy - Hemorrhoids

[KoBee]

would like some input on a discussion regarding for MEDICARE when doing a screening colonoscopy. Pt is a 70 yrs old having a screening colonscopy with no hx of any. Not high risk.

If intention is to do a screening and there is hemorrhoids and diverticulosis.

Coding be:

G0121
Z12.11
Followed by Dx findings (hemorroids/diverticulosis)

or

45378
modifier PT
Z12.11
Followed by Dx findings (hemorroids/diverticulosis)

 

[thomas7331]

The coding would depend on what was documented in the operative report, but your first scenario is most likely the correct one. If the procedure was only a screening and the hemorrhoids and diverticulosis were merely incidental findings that were noted, then the G0121 is appropriate. But if the provider performed any collection of specimens by brushing or washing due to the findings, then you could report 45378-PT as a screening converted to diagnostic since the extra work of the specimen collection is included in the 45378 code but not in the G0121.