Reader Question: Payers May Disagree About Colon Biopsy Diagnosis Code

Article Overview

This article addresses a common coding and billing scenario involving a colon biopsy obtained during a screening colonoscopy that is later treated as diagnostic. It explains that reporting expectations may vary by payer, and it highlights how pathology, physician, and Medicare-related rules can differ in what diagnosis information is placed first or carried forward on the claim. The piece is relevant to coders, billers, pathology staff, and physician practices that handle colorectal screening and diagnostic follow-up claims.