I recently coded a pathology report for a colonoscopy specimen (CPT 88305-26, DX Z12.11) which was denied payment by BCBS.

Pre-operative dx is: Screening for malignant neoplasm of colon.

In the report Gross description states:Specimen labeled, "colon polyp at 54cm." The specimen consist of tiny flecks of white material less than 1 mm. Collected in a tissue sack. All submitted.

Microscopic Description; Sample is crushed hemorrhagic colonic glands and stroma. There is no specific histological abnormality.

Final Pathological Diagnosis Large intestine, 54 cm, biopsy: No diagnostic alteration.

I’ve been asked by management to change the dx to D12.4 (Benign neoplasm of descending colon) and rebill the claim.

I don’t feel the diagnosis D12.4 is supported by the dictation in the report and am looking for some outside opinions.

Any input is welcome, thank you.