tci General Surgery Coding Alert - 2006 Issue 9

Colonoscopy Confusion May Have Only 1 Solution

Carriers differ on primary diagnosis for -diagnostic- screenings The confusion over how to report screening colon-oscopies that become -diagnostic- has intensified further over the past several months. With no end to the debate in sight, your only answer may be to ask for written instructions from your individual carrier. Background: In February, CMS officials clarified that when a screening colonoscopy finds a polyp, you should bill using the polyp diagnosis, not the screening V code. (See Reader Question, -Screening-vs.-Diagnostic Rules Haven't Changed- on page 39 of the May 2006 General Surgery Coding Alert.) Example: For Medicare...

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