What CPT code is used for screening colonoscopy?

What CPT code is used for screening colonoscopy?

What’s the right code to use for screening colonoscopy? For commercial and Medicaid patients, use CPT code 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression [separate procedure]).

How do I bill a 45380?

CPT code 45380 is used for billing services when flexible colonoscopy is performed by taking single or multiple biopsies. The colonoscope is introduced into the patient’s body via the anus. It traverses through the whole colon to the cecum in order to visualize the lumen of the colon and rectum.

Is 45380 a screening colonoscopy?

A family of CPT codes applies to colonoscopy. For example, code 45378 applies to a colonoscopy in which no polyp is detected, while codes 45380-45385 apply to colonoscopy that involves an intervention (e.g., 45385 is the code for colonoscopy with polypectomy.)

What is the difference between a diagnostic colonoscopy and a screening colonoscopy?

A screening colonoscopy will have no out-of-pocket costs for patients (such as co-pays or deductibles). A “diagnostic” colonoscopy is a colonoscopy that is done to investigate abnormal symptoms, tests, prior conditions or family history.

How do you code a colonoscopy with a biopsy and polypectomy?

45385–33: Colonoscopy with snare polypectomy; modifier to indicate preventative screening procedure. 45380–59: Colonoscopy with biopsy, single or multiple; modifier to indicate distinct procedures. Note: report only once, even if multiple polyps are removed by the same technique.

Are there 2 types of colonoscopy?

There are two types of colonoscopy: screening and diagnostic. Talk to you doctor about which you may need and understand your benefits for both types before the procedure.

Is a colonoscopy considered preventive or diagnostic?

A colonoscopy is considered preventive screening if the patient doesn’t have any gastrointestinal symptoms and no polyps or masses are found during the colonoscopy. The Affordable Care Act (ACA) considers preventive services “essential health benefits” and requires insurance companies to pay all associated costs.

What is the CPT code for polypectomy?

CPT 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique. The snare technique is usually used to perform a polypectomy during a colonoscopy.

What is the difference between a routine colonoscopy and a diagnostic colonoscopy?

Is a colonoscopy preventive or diagnostic?