Z12. 11 encounter for screening for malignant neoplasm of colon.
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.
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.
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
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.
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.
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 .
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? A visit prior to a screening colonoscopy for a healthy patient is not billable.
19.
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 .
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.