Gastroenterology ICD-9 coding for screenings

When is it appropriate to use the V70.0 versus the V76.51 when a patient is having a screening colonoscopy? We are getting conflicting information from insurance carriers...

"Who makes the rules? Some one else" (Oingo Boingo)

It is never appropriate to use v70.0 for a screening colonoscopy...unless the payor tells you to use it to get paid.
Every day we are faced with rules that make no sense but we must follow them to get paid- another example- the use of Observation status in the hospital for normal post-op recovery. Medicare calls that fraud, Blue Cross says you have to bill Observation or they won't pay for the surgery.
So make up a grid with the payors and their preferred codes and use that, and don't try to argue their logic- it's not worth the effort.

ICD 9 for colonoscopy

This is why I like Medicare: at least they publish their rules. Of course, some private payers now do too, and have pretty informative websites.

If your private payers wants a general screening code, then you can submit the V70.0, but I would think they would be in the minority. Whenever they ask you to do something that doesn't follow typical coding rules, ask for it in writing.

If you look at the article on colonoscopy in Codapedia, http://www.codapedia.com/~article_169_.cfm

it sends you to the Medicare Claims Processing Manual:

http://www.cms.hhs.gov/manuals/iom/
From publication 100-04, download chapter 18, Section 60 tells you in detail about Medicare's policies.

Also, there is Medicare's quick reference chart for covered preventive services, and that is a quick reference. That might be helpful.