Wiki Screening vs diagnostic?

[MSCURTISK]

If patient is having problems such as Abdominal pain & change of bowel habits, BUT is overdue for their colon screening, should you code this as screening OR diagnostic colonoscopy?
thanks

Karin & Jan

 

[btadlock1]

If patient is having problems such as Abdominal pain & change of bowel habits, BUT is overdue for their colon screening, should you code this as screening OR diagnostic colonoscopy?
thanks

Karin & Jan

It really depends on what the referring provider documented for the indication. If the purpose of the colonoscopy is to rule out any suspected conditions, or if it's being done ato assess the abdominal pain/bowel issues, it's diagnostic, regardless of whether they were due for one or not. You can't bill it as screening, when the record shows that it's diagnostic, even if the screening would be covered @ 100%.

 

[coachlang3]

To further point out what Brandi is saying:

Did the patient come in to see your doctor for the abdominal pain or did the patient come in for a screening?

Does the doctor want to do the colonoscopy because of the pain or because of the screening?

It has to be one or the other and you need to let the patient know the reason why your doctor wants to do it.

 

[MSCURTISK]

Screening vs diagnostic

just wanted to say Thank You to you both for reply.
Sometimes our physicians and/or patients question our coding judgement, so it is great to have this forum just to reinforce what you already know sometimes..

thank you again, appreciate your input

Karin