Charlene Posted Wed 13th of February, 2019 09:36:43 AM
Patient had no symptoms and was undergoing screening colonoscopy. At the hepatic flexure a tight curve could not be negotiated after multiple maneuvers, and the procedure was stopped. The procedure code is G0121-53. Since the patient was without symptoms, I'm thinking Z12.11 should be used, but what other dx code do I use to explain the incomplete procedure? The patient was not clinically obstructed.
SuperCoder Answered Thu 14th of February, 2019 06:15:10 AM
It is appropriate to use G0121-53 and Z12.11 for the above procedure. However, you may also use diagnosis code K56.6 (other and unspecified intestinal obstruction) to give reason for hepatic flexure as tight curve, since there is no definite diagnosis made to mention as to why the procedure was incomplete. Feel free to ask for any further query.
Charlene Posted Mon 18th of February, 2019 17:11:16 PM
The provider said the colon was normal, but had a curve that he could not negotiate. Codes submitted for provider were G0121-53 and Z12.11. The patient had a follow up barium enema which was normal. The ASC used K56.2/volvulus, therefore, insurance voided screening benefit and applied the exam to the patient's deductible.
SuperCoder Answered Tue 19th of February, 2019 01:20:19 AM
It is appropriate to use K56.6 because other and unspecified intestinal obstruction will cover everything even if there is any tightness or bend, (which may occur due to age) in normal curvature of hepatic flexure. If there is no definite diagnosis of volvulus, then we cannot use K56.2. Or you may check for the chief complains as well and use K59.8 (Pseudo-obstruction (acute) (chronic) of intestine, if documentation supports. Hope it helps.