Fit Your Colonoscopy Exam Coding As Per Diagnosis

By Author: Angela Martin
Total Articles: 206
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If your gastroenterologist carries out colonoscopy screening on a patient, you must always link a ‘screening' diagnosis to the procedure even if the doctor discovers any abnormality in the process.

In a nutshell, your doctor's findings will dictate how you'll tackle your colonoscopy coding. Here're some important ideas on what to expect.

Put G codes into good use for screenings

You have 2 G codes as an option when reporting colonoscopy screenings for Medicare-eligible patients: G0105 or G0121. You should support G0105 for high-risk patients with selected diagnoses.

Medicare also allows inflammatory bowel diseases as primary diagnosis for G0105. If your gastroenterologist clears the patient of any high risk for colorectal cancer, you would use a primary diagnosis of V76.51 to support G0121.

Turn code-specific for abnormal findings

If your gastroenterologist finds a lesion during a screening exam, and carries out a biopsy or removal, it should be a different story. In this situation, you ...
... should forget about G codes, and rely on a diagnostic colonoscopy code that specifically describes the resulting procedure.

Do not touch your V codes

Even if the gastroenterologist biopsies or does away with a lesion during what began as a screening colonoscopy, you should still retain the right V code as your primary diagnosis.

Whether an abnormality is found or not, if a service to a Medicare beneficiary starts out as a screening examination, then the primary diagnosis should be indicated on the form CMS-1500 using the ICD-9 code for screening examination.

For more tips on ways to tackle your colonoscopy coding, sign up for an audio conference. You can have access to such a webinar on your PC too. What's more, you even stand to acquire CEUs on attending such a conference.