AHA Coding Clinic® for ICD-10-CM and ICD-10-PCS - 2019 Issue 1; Ask the Editor
Cologuard® Test
A patient underwent a colonoscopy because of a positive Cologuard® test. The colonoscopy demonstrated no abnormal findings. What is the appropriate diagnosis code for this encounter? ...
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Article Overview
This premium article addresses diagnosis coding for a colonoscopy performed after a positive Cologuard® test when no abnormal findings are seen on the procedure. It is intended for coding professionals, billers, auditors, and clinicians who need to understand how the encounter is categorized and how the Official Guidelines for Coding and Reporting apply in this situation. The discussion focuses on the coding principle that drives diagnosis sequencing for diagnostic services and the related selection of an appropriate diagnosis code.
Why This Topic Matters
Correctly classifying encounters that begin with a positive noninvasive colorectal screening test and proceed to diagnostic colonoscopy is important for accurate claim submission, compliant diagnosis sequencing, and consistent reporting. The article helps reduce coding uncertainty in a common preventive-to-diagnostic workflow.
What You Will Learn
- How an encounter involving a positive Cologuard® result and a follow-up colonoscopy is framed for coding purposes
- How official outpatient diagnosis sequencing guidance affects this type of encounter
- What broad category of diagnosis is associated with the abnormal test finding in this scenario
- How the article relates the clinical scenario to general reporting guidance for diagnostic services
Who Should Read This
- Medical coders
- Coding auditors
- Billing professionals
- Revenue cycle staff
- Clinicians documenting diagnostic encounters
Codes Discussed
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