Wiki Screening dx vs rectal bleeding

[Colliemom]

When a patient is sent to us because she is 55 years old, and it's time for a screening colonoscopy, we use the screening for colon cancer dx. But when the same patient comes in, and during the course of her visit, she admits that yes, she has had a little rectal bleeding and diarrhea in the past, should the primary dx be changed? We were under the impression that we still bill the V76.51 as the primary dx, and then list the rectal bleeding and diarrhea as secondary dx. Is this correct?

 

[bridgettemartin]

Still a screening

My opinion...in this scenario, the patient was still referred for a screening colon. If during the pre-op H&P they mention they've had intermittent diarrhea for years, or intermittent RB, I would still code it as a screening and list the incidental symptoms secondary. Now, if during that pre-op exam the Dr. determines that their diarrhea is substantial, and now he's going to investigate causes of their diarrhea, then it could be considered diagnostic.
Hope this helps!