Forum - Questions & Answers

Jul 21st, 2016 - miawalker 2 

office visit prior to screening colonoscopy

Hi everyone:)

Recently our office was told by BC state (SC) they would pay for an office visit prior to a screening colonoscopy but only if we coded it with an op consult code (99241 - 99245) which makes no sense to me. If the visit isn't medically necessary and not an opinion or advice being sought by another physician, etc. how could it possible be a consult? Also, they are requesting Z12.11 be used as primary with the consult code.

Any advice is appreciated.


Thanks

MRW

Jul 21st, 2016 - abenet 5 

re: office visit prior to screening colonoscopy

Payers can seem to have their own rules. I would ask for that in writing. Do not just accept what you are told in conversation. Perhaps they have a policy that defines their criteria.



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