tci Part B Insider - 2013 Issue 22

Reader Question: Assess Risk to Arrive at Diagnosis Code Rather Than Payer Type

Question: We have patients from time to time whose benefit plans don’t recognize high risk screening codes, i.e.: V10.05,V12.72 and will apply their diagnostic benefits instead of screening/preventative benefits. I’ve been taught that you can’t bill V76.51 as primary dx on a high risk patient. You have to list the high risk code as primary. Example:Patient is having colonoscopy for personal history of colon cancer, V10.05. Nothing was found during procedure and we billed 45378 w/ V10.05 but the patient’s plan doesn’t recognize V10.05 under...

To read the full article, sign in and subscribe to tci Part B Insider.


Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.