tci General Surgery Coding Alert - 2014 Issue 6

Case Study: Payer, Risk, and Findings Drive Colonoscopy Code Choices

See how one little modifier can help. If just thinking about colonoscopy coding gives you a headache because of all the convoluted coverage and billing rules, you’re not alone.  But if you follow the logic of this one simple case, along with our expert’s explanations of code options for variations, you’ll be prepared to face any colonoscopy case your surgeons throw at you. Scenario: A non-Medicare patient has a family history of colon cancer and presents for her second screening colonoscopy five years after her initial procedure. During the screening, the surgeon finds and excises...

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