Colonoscopies and Diverticulosis

Can a physician bill for a screening colonoscopy for colorectal cancer (V76.51) if the patient has known diverticulosis? The patient's diverticulosis is noted on the H&P but the patient is being seen for a screening. On the indications for his op report the provider lists "screening" and he documents the colonoscopy. There may or may not be polyps removed and the diverticulosis is noted. There's some debate as to whether or not this can still be called a screening. Since the patient is not having signs or symptoms of what's being screened (cancer), should it still be considered screening? On the other hand, we don't have signs or symptoms but we do have a known disease before the colonoscopy. Does this make it diagnostic even if the intent by the physician was a screening? Any thoughts and references would be appreciated!
Thanks,
Tammy

don't know the answer....but

I've always heard that diverticulosis and diverticulitis are "incidental" findings that don't even have to be reported...like hemorrhoids. So...while I don't know your answer for sure, my opinion would be that it would still be a screening. You could report the diverticulosis as a secondary diagnosis. But....I'm still unclear on all the screening rules...so I'd like to hear what others say about this.

toss-up

Screening colonoscopies-- only the screening diagnosis and not the diverticulosis (562.10) diagnosis should be used even if the surgeon subsequently counsels the patient on healthier eating habits and lifestyles, in most cases and many payers.
Some Medicare carriers have stated in their bulletins that if the diverticulosis is more than incidental (i.e., significant) and some form of treatment (which would include dietary counseling, for instance) is provided, the colonoscopy becomes a diagnostic procedure and diverticulosis may be used as the supporting diagnosis.