ASGE members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ASGE member’s name and ID number. Only questions will be accepted and not reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.
Question: A patient had a colonoscopy. The indication is a positive Cologuard performed for weight loss. I confirmed with the provider that the Cologuard was part of a workup for weight loss. I know the Cologuard should not have been done because of weight loss, but because it was, does this make the colonoscopy diagnostic for a positive Cologuard and weight loss, or should this be billed as a screening for a positive Cologuard? The patient's insurance is MCR.
Answer: If the colonoscopy was performed to assess the cause of the weight loss, it was diagnostic. Cologuard is indicated for average-risk screening only.