COLONOSCOPY BILLING INFORMATION

A Routine Preventative (Screening) Exam requires that the patient have no current complaint or significant problem/abnormality or surveillance of chronic/active condition (sign or symptom, i.e., rectal bleed, diarrhea, colitis, etc.) that they are aware of or have reported to the physician or staff. If you have reported a sign or symptom that no longer exists you must let the physician know so he can exclude it from his operative note or note that it no longer exists.

Please note that if you have a family history or personal history of colon cancer or colon polyps, we will note a Screening Colon code with the History code to try and make the screening situation clear to your insurance company.

If you have a current or significant problem (i.e., rectal bleeding, diarrhea or colitis, etc.) the colonoscopy is NOT a screening procedure.

This office will file a claim on your behalf, however, you must understand that this office can only code and file a claim for your procedure with a diagnosis that was encountered and documented on the operative report. This office cannot comply with any request to alter the medical record or claim for the purpose of securing payment from any insurance carrier which may be considered a fraudulent act.