Wiki Screening versus Diagnostic Colonoscopies

[momo2]

I was just wondering if anyone could enlighten me about coding colonoscopies....

If a patient is 50 or over and and is coming in for a colonoscopy it should be colded as:

v76.51 + the finding (e.g polyps, diverticulosis, etc)

If a patinet has a personal or family hx of colon cancer, it should be coded as:

v76.51, v12.72 or V16.0 and the findings??? what if they find colon polps? Is it appropriate to use v12.72or v16.0 with 211.3? Some people suggest that I should not use the v12.72 or v16.0if they find polyps????

Thanks for any help!!!

 

[EricaR]

Have you read the article in the Coding Edge? It is pretty helpful; I believe it was in Feb or March.

Erica

 

[simpsonc]

Have you read the article in the Coding Edge? It is pretty helpful; I believe it was in Feb or March.

Erica

Hi Erica,

I did read the article in the March 2013 issue, and I am still uncertain about one thing - what order to report Dx codes. For example, if a patient is asymptomatic and presents for a "Surveillance Colonoscopy" due to a personal history of colon polyps; and a polyp is found and removed via snare; would you code the V12.72 (personal hx of colon polyps) as the primary Dx and the 211.3 secondary or vice versa?

Also, something not touched on in the article, would you append a 33 modifier to a service that was intended for surveillance purposes since the original intent was for a non-diagnostic (preventative?) service?

Thanks!

Cassey

 

[lillusdw]

Hi Erica,

I did read the article in the March 2013 issue, and I am still uncertain about one thing - what order to report Dx codes. For example, if a patient is asymptomatic and presents for a "Surveillance Colonoscopy" due to a personal history of colon polyps; and a polyp is found and removed via snare; would you code the V12.72 (personal hx of colon polyps) as the primary Dx and the 211.3 secondary or vice versa?

Also, something not touched on in the article, would you append a 33 modifier to a service that was intended for surveillance purposes since the original intent was for a non-diagnostic (preventative?) service?

Thanks!

Cassey

Cassey,

I would code as follows: V67.09 surveillence then the findings ie:211.3 then the hx of V12.72 I do not use the 33 modifier. Hope this helps.

Lillus Hayes CPC

 

[simpsonc]

Cassey,

I would code as follows: V67.09 surveillence then the findings ie:211.3 then the hx of V12.72 I do not use the 33 modifier. Hope this helps.

Lillus Hayes CPC

Hi Lillus,

Would it still be appropriate to use the V67.09 primary if the patient returns for surveillance 2 or 3 years later? I don't normally use this diagnosis because I was under the impression that it signified a follow-up immediately post-op. What's your opinion on the time frame for usage?

Thanks,

Cassey

 

[bridgettemartin]

I was just wondering if anyone could enlighten me about coding colonoscopies....

If a patient is 50 or over and and is coming in for a colonoscopy it should be colded as:

v76.51 + the finding (e.g polyps, diverticulosis, etc)

If a patinet has a personal or family hx of colon cancer, it should be coded as:

v76.51, v12.72 or V16.0 and the findings??? what if they find colon polps? Is it appropriate to use v12.72or v16.0 with 211.3? Some people suggest that I should not use the v12.72 or v16.0if they find polyps????

Thanks for any help!!!

If you do a search on this forum you will find several posts/responses on this topic.
For screening/surveillance colonoscopies, the primary code should be the reason they came. If a polyp is a removed,you submit the appropriate CPT code, with V76.51(or v12.72) followed by the 211.3. We attach the -33 modifier (PT for medicare) to indicate the service was preventative.