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Family hx of colon cancer/polyps

Wanett Posted Mon 22nd of November, 2010 16:53:25 PM

If a pt is having a routine V76.51 colon screening but they have a family history of colon cancer or colon polyps, is the V76.51 the first dx and the 'history of (V16.0)' code 2nd? Thanks for any info.

Marilyn Answered Mon 22nd of November, 2010 16:59:01 PM

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SuperCoder Answered Mon 22nd of November, 2010 20:07:30 PM

You are absolutely right.

For a Medicare patient, code selections for colorectal screenings should include V76.51 as the primary diagnosis. Then you must check if the patient is considered a high risk. There are specific criteria that CMS requires for a patient to be categorized as “high risk.” To establish the patient as “high risk,” the patient should exhibit one or more of the conditions found on the CMS list, which you should report as a secondary diagnosis to V76.51.

Here are some examples:
V10.05—Personal history of malignant neoplasm, large intestine
V12.72—Personal history of colonic polyps
V16.0 — Family history of malignant neoplasm; gastrointestinal tract
556.0—Ulcerative (chronic) enterocolitis

For the complete list refer to: http://www.cms.hhs.gov/

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