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BC Advantage - 2018 Issue 1

How to Code Screening and Diagnostic Colonoscopy

Summary: Providers need to be knowledgeable about the distinction between diagnostic and screening colonoscopy as well as specific payer codes and rules.  Colonoscopy is a common procedure performed by Gastroenterologists. CPT defines a colonoscopy examination as "the examination of the entire colon, from the rectum to the cecum or colon-small intestine anastomosis, and may include examination of the terminal ileum or small intestine proximal to an anastomosis" as well. Coding for screening colonoscopies and assigning modifiers can be challenging for providers. To report services correctly, physicians and medical coding service providers need to understand the difference between diagnostic...

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