Wiki Screening vs. Diagnostic

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Would love some input, Report states indication for procedure to ASC for follw-up UC, no symptoms, Dr. takes biopsies, everything normal, recommends colon in 3 years. Is this a screening or diagnostic colonoscopy?/ We also are having issue with patients that have a history of colon polyps, Boarded for Hx colon polyps, have procedure and everything normal, Is this a screening or is it diagnostic? These are patients with BX insurance, no Medicare involvement.
Would appreciate any advice for coding these instances.
 
In your first example I would say it would be diagnostic due to the line " for follow-up UC".

So the dx would be V67.09 (follow up) and then V12.79 (hx psnl digestive disease NEC)

For your second example there a couple of ways to look at it and it depends on a couple of factors including how the doctor dictated the indication, the patients policy and your contract with the payor.

If the doctor has indications as CCS and hx of polyps then I would code it as V76.51, V12.72 and then the findings with the 33 modifier.

If he just dictated indications as hx of polyps then V67.09, V12.72 and then the findings.

Now, I know others will come in and say no way the hx of polyps makes it diagnostic no matter what. I just disagree with them but only if the doctor also puts in the indication "CCS" or colon cancer screening.

So take what I said and also take what they say and use it to the best of your ability.
 
Thanks for responding! :) Our reports will ususally state indication: Screening for history of colon polyps, And we use V76.51 V12.72 as 2ndary and then findings.
 
screening

I have found many Dr's do not know how to word their office visits or Op reports. Once a pt has polyps it is always diagnostic. Even if their report says screening with hx of polyps you report the v12.72 only, not the v76.51. Insurance company's will pay the v76.51 and v12.72 and 33 mod if something more was found but it is not correct coding. Please review Oct and March issues of Cutting edge regarding this topic.
 
One of the things that bumps a screening up from a normal risk to high risk is personal history of adenomatous polyps.

If having a hx of poylps meant every visit for life is now diagnostic, then why would there even be guidelines on the above scenario?
 
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