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Hx of polyps V12.72 with new insurance coverage

Susan Posted Wed 30th of April, 2014 16:42:58 PM

Patient has a hx of polyps v12.72 is due for a surveillance screening. She is now covered by Medicare. Since the patient has not had a screening with medicare could I use the V76.51 and V12.72 or just schedule her due to hx v12.72 with the G0105?

SuperCoder Answered Wed 30th of April, 2014 23:50:54 PM

A patient who is considered at high risk for colorectal cancer is entitled to a screening colonoscopy once every 24 months. You'll list a V code (such as V10.05, Personal history of malignant neoplasm; large intestine; or V12.72, Personal history of certain other diseases; diseases of digestive system; colonic polyps) as the primary diagnosis for these tests -- most of the time.

Exception: If a patient has a condition that automatically puts him at high risk for colorectal cancer, then you would list that condition as the primary diagnosis (for instance, Crohn's disease or ulcerative colitis; check your spell local coverage determination [LCD] for your payer's specific list).

Your case - G0105/V12.72

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