Gastroenterology Coding and Billing Guidelines

One must keep note of the distinction between screening colonoscopy and diagnostic colonoscopy. In doing such screening colonoscopy, one may discover any issues, and so, it becomes a diagnostic colonoscopy and the patient will be responsible for a copay. Also, if there is a need to prevent a colonoscopy due to poor preparation, do not forget to add modifier 53.

In addition to that, if the CPT does not reflect and get additional time or complexity for, then use modifier 22. The utilization of modifiers 52 and 53 can lead to confusion, and usually, there is a special chart on the specific area of the digestive system that the scope was able to get through for colonoscopy.

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