What ICD 10 DX code covers CPT 45378?

What ICD 10 DX code covers CPT 45378?

Report 45378 with ICD-10 code Z86. 010 on the first line of the CMS 1500 form.

Is CPT 45378 a 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]).

Does CPT 45378 require a modifier?

CPT code 45378 is the base code for a colonoscopy without biopsy or other interventions. Medicare has a separate modifier for situations in which polyps are found and removed during a screening colonoscopy. In these instances, the correct CPT code is used (for example, 45385), but with modifier PT.

Is Z12 11 a preventive code?

The colonoscopy or sigmoidoscopy is still classified as a preventive service eligible for coverage at the no-member-cost-share benefit level. a. Submit the claim with Z12. 11 (Encounter for screening for malignant neoplasm of colon) as the first-listed diagnosis code; this is the reason for the service or encounter.

Is CPT 45380 diagnostic?

1. Diagnostic / Therapeutic Colonoscopy – Patient has gastrointestinal symptoms, colon polyps, or gastrointestinal disease requiring evaluation or treatment by colonoscopy (CPT Code: 45380 – See # 1 below).

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

A diagnostic colonoscopy, while basically the same procedure, is used in different situations than a screening colonoscopy. Diagnostic colonoscopies are used when a patient exhibits specific symptoms that may indicate colon cancer or other issues.

What is the difference between CPT 45380 and 45378?

Insurance billing codes for screening colonoscopy have two components. 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.)

Can Z12 11 be a primary diagnosis?

If the patient presents for a screening colonoscopy and a polyp or any other lesion/diagnosis is found, the primary diagnosis is still going to be Z12. 11, Encounter for screening for malignant neoplasm of colon as the first listed code. Surveillance colonoscopies are still screenings.