Wiki Screening Colonoscopy discontinued

[suec]

With the 2015 changes, looking for opinions on how this should be coded from a hospital perspective.

Medicare patient came in for a screening colonoscopy. (intent was to reach the cecum - would have coded G0121) The scope was not advanced pass the splenic flexure, procedure stopped. The new changes indicate this would be coded as 45330 or do we use G0104? (because it was a screening)

Does the coding change if the patient was rescheduled for another colonoscopy the following week? 45330-74 or G0104 with no modifier or 45378-74 or G0121.

Not sure what code or modifier to use because this was a discontinued screening colonoscopy.

Thanks for the help
Sue

 

[clarkmegan]

I would code G0121-74 if it does not make it to the cecum. The professional charges should be G0121-53. This puts a stop on the time interval so that the repeat procedure is not denied for frequency. I would also place the V64.3 after V76.51 on the claim

 

[suec]

Screening Colonoscopy discontinued reply

Thanks for the reply. Would you still use G0121-74 even if the scope only made it to the sigmoid colon before aborting? Or would G0104-74 be more appropriate? Agree with the diagnosis codes.

diagnosis codes, diagnosis coding

 

[afalcon@dhcla.com]

The table in the CPT book for coding colons is wrong. I agree with megan

diagnosis codes, diagnosis coding

 

[suec]

Thank you both for your input!

diagnosis codes, diagnosis coding