Our office and facility need clarification on colonoscopy coding for polyp surveillance. Some are saying it should be a high risk screening due to polyps (CPT 45378, DX: Z12.11, Z86.010) and patient's insurance will pay 100%. The other opinion is that it should be a surveillance colonoscopy due to polyps (CPT 45378, DX: Z86.010) and patient's deductible/co-insurance would apply.
Cannot find specific CMS guidelines in regards to this. Any help would be appreciated!!
Melanie
Cannot find specific CMS guidelines in regards to this. Any help would be appreciated!!
Melanie
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