icd 10 code for colonoscopy referral

by Prof. Furman Brown 3 min read

A screening colonoscopy should be reported with the following International Classification of Diseases, 10th edition (ICD-10) codes: Z12. 11: Encounter for screening for malignant neoplasm of the colon. Z80.May 1, 2016

What is a Z12 11?

Z12. 11 encounter for screening for malignant neoplasm of colon.

How do I code a Medicare screening colonoscopy?

G0121 – Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk.G0105 – Colorectal cancer screening; colonoscopy on individual at high risk.G0104 – Colorectal cancer screening; flexible sigmoidoscopy.

Can Z12 11 be a primary diagnosis?

If the patient presents for a screening colonoscopy and a polyp or any other lesion/diagnosis is found, the primary diagnosis is still going to be Z12. 11, Encounter for screening for malignant neoplasm of colon. The coder should also report the polyp or findings as additional diagnosis codes.

What is the CPT code for a diagnostic colonoscopy?

Group 1CodeDescription45378COLONOSCOPY, FLEXIBLE; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)45379COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S)45380COLONOSCOPY, FLEXIBLE; WITH BIOPSY, SINGLE OR MULTIPLE22 more rows

What is the difference between a screening and diagnostic colonoscopy?

A screening colonoscopy will have no out-of-pocket costs for patients (such as co-pays or deductibles). A “diagnostic” colonoscopy is a colonoscopy that is done to investigate abnormal symptoms, tests, prior conditions or family history.

Does Medicare require prior authorization for colonoscopy?

Many people have extra coverage. However, Medicare requires prior authorization for a colonoscopy before most advantage plans start paying. Pre-approval means your doctor must get a green light before sending you to a Gastroenterologist.

What does Z12 12 mean?

ICD-10 code Z12. 12 for Encounter for screening for malignant neoplasm of rectum is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

What does code Z12 31 mean?

For example, Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is the correct code to use when you are ordering a routine mammogram for a patient.

How do I bill for a patient seen in our office prior to a screening colonoscopy with no GI symptoms and WHO is otherwise healthy?

How do I bill for a patient seen in our office prior to a screening colonoscopy with no GI symptoms and who is otherwise healthy? A visit prior to a screening colonoscopy for a healthy patient is not billable.

What is the ICD 10 code for poor preparation for colonoscopy?

19.

What is the ICD 10 code for colon polyps?

ICD-10 code K63. 5 for Polyp of colon is a medical classification as listed by WHO under the range - Diseases of the digestive system .

What is the difference between 45380 and 45385?

45380—Colonoscopy, with biopsy, single or multiple. Hint: The physician may use the words “biopsy forceps,” or “Jumbo forceps.” Fee amount $468.96. 45385—Colonoscopy, with removal of tumor(s), polyp(s), lesion(s) by snare technique.