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Billing Tidbits: How to Bill for Incomplete Colonoscopies

Why You Could Need Colonoscopy

colonoscopyNow you have to know that there are a number of conditions and diseases that could be related to your colon. It is after all a part of your internal structure dealing with extremely nuclear material that your body can produce including leftover nucleic waste and pepsin and gastric juices and colorectal binding agents, I’m not helping am I? Well let’s just say that your colon is also prone to infection and viral diseases or on more serious note it could be a tumour or a haemorrhage which will lead to infection or the worst thing possible, colon cancer.

 

Colonoscopy And How it’s Performed

Now the doctors have to be sure that the problem in your colon is not a tumour or a cancer. For that they have to look inside your colon and meanwhile that doesn’t sound like a very good perspective at all, it is still better than the doctors performing surgery just to see if you have a tumour up your colon. The best procedure in these cases is a colonoscopy. It is thin wire with a camera and a pinpoint light attached to its end. The doctor puts it up your anal cavity and pushes it further towards your colon to your intestines to see the cause of your problem. The light and camera allows them to see if there is a tumor or cancer inside. It is the least minimally invasive technique. And while it sounds awfully painful and disgusting, it is complete surgical procedure which requires an OR and the surgeon and even a specialist on-call. So safe to say that this procedure does cost.

 

Incomplete Colonoscopies

There are a lot of colonoscopies that do not get completed. There are a few reasons why that might happen. There might be an obstruction which does not allow the scope to go any further or the patient might find it too painful or any other unforeseen circumstance. At this point, it becomes very hard for the patient and the hospital to determine how to bill for an incomplete colonoscopy. There has to be a way to determine whether the colonoscopy was completed or not. This is where coding comes in.

 

How to Bill Incomplete Colonoscopies

Incomplete Colonoscopies

A code is a medical term. A code of a procedure is the specification of the procedure’s specifics in the medical terms. A code helps specify what kind of procedure was performed on the patient. In the case of determining how to bill for an incomplete colonoscopy, it becomes very important that it should be established an incomplete colonoscopy. For that the American Academy of Professional Coders (AAPC) has established a proper code. For instance, when you have to bill for an incomplete colonoscopy, you have to make sure of the following things:

  • Make sure that the scope did not pass the splenic fixture.
  • The procedure is coded properly as per the diagnosis.
  • The right code is entered in the Medicare Physician Fee Schedule Database (MPFSDB)