Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

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2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers

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Click here for more sample CPC practice exam questions and answers with full rationale

Code Colonoscopies With Precision

Accurate billing of these procedures requires attention to detail. Colonoscopy is a medical procedure in which the physician inserts a long, flexible, tubular instrument called a colonoscope into the patient’s anus to examine the lining of the entire colon for abnormalities and disease conditions. This type of test may be performed as a colorectal cancer […]

The post Code Colonoscopies With Precision appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Colonoscopies- Technique Billing

Hello, I need some clarification. If a surgeon performs a colonoscopy, ie. polypectomy (cautery snare and hot biopsy forcep). Don’t you bill for both? I always have but wanted to make sure. I will place the note below.
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The patient was brought back to the endoscopy suite and was properly monitored and positioned. IV sedation was administered. The anal verge was inspected. A digital rectal exam was performed. The Olympus video colonoscope was then inserted and passed under direct vision to the cecum. The degree of difficulty was minimal. The prep was good. The scope was then withdrawn carefully inspecting all areas of the lower GI tract. Retroflexion was performed in the rectum. Endoscopic findings included see above. Therapeutic procedures included polypectomy using the hot biopsy forceps and cautery snare. Polypectomy site hemostatic. The scope was then withdrawn and the patient tolerated the procedure well.

45385, 45384-59?

Thanks in advance! :)
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Medical Billing and Coding Forum

Rates Change for Incomplete Colonoscopies in Critical Access Hospitals

Remember back in 2015 when CPT® changed the definition of an incomplete colonoscopy from one that does not evaluate the colon past the splenic flexure to one that does not evaluate the entire colon? The Centers for Medicare & Medicaid Services (CMS) is responding to that change, albeit rather lethargically. CPT® 2015 stated (and continues to […]

The post Rates Change for Incomplete Colonoscopies in Critical Access Hospitals appeared first on AAPC Knowledge Center.

AAPC Knowledge Center

Screening colonoscopies

ok, this is going to sound odd…but I was asked to check.

When performing a screening colonoscopy, we usually use the dx code Z12.11, screening for malignant neoplasm of the colon. I was just asked why wouldn’t we also use Z12.12, screening for malignant neoplasm of the rectum? I’m assuming, but could be wrong, that you would only need Z12.11, as the screening of the colon includes the rectum. (but it doesn’t actually specify this in the description) What are your thoughts? Have you ever had a provider bill a colonoscopy with both Z12.11 and Z12.12?

Medical Billing and Coding Forum

using pathology report to code for Colonoscopies

I believe that the best way to code colonoscopies with biopsies is to wait for the path report.

my physicians feel that"waiting for the path report delays claim filing, doesnt help with reimbursement and adds undue work" and that i should just go ahead with the k63.5 dx

anyone else in this dilemma?

Medical Billing and Coding Forum

New Values for Incomplete Colonoscopies Billed with Modifier 53


An incomplete colonoscopy, e.g., the inability to advance the colonoscope to the cecum or colon-small intestine anastomosis due to unforeseen circumstances, is billed and paid using colonoscopy through stoma code 44388, colonoscopy code 45378, and screening colonoscopy codes G0105 and G0121 with modifier “-53.” (Code 44388 is valid with modifier 53 beginning January 1, 2016.) The Medicare physician fee schedule database has specific values for codes 44388-53, 45378-53, G0105-53 and G0121-53. An incomplete colonoscopy performed prior to January 1, 2016, is paid at the same rate as a sigmoidoscopy. Beginning January 1, 2016,

Medicare will pay for the interrupted colonoscopy at a rate that is calculated using one-half the value of the inputs for the codes.

Reference: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM9317.pdf


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