Colonoscopy Coding for Outpatients
Description
Colonoscopy Coding for Outpatients is an online, self-paced course for outpatient and professional fee coders who assign CPT and ICD-10-CM codes for colonoscopy services. This course explains how to code screening, diagnostic, and follow-up colonoscopies, with clear guidance on diagnosis selection, modifier use, and the transition from screening to diagnostic procedures. Coders will also learn how to report polyp and lesion removals accurately while applying current coding guidelines. The course includes 1 AHIMA CEU and helps coders improve accuracy and consistency when coding outpatient colonoscopy procedures.
Included Lessons:
- What is a Colonoscopy?
- Photo of Large Intestine
- Problems with Coding Coloscopies
- Diagnosis Coding for Outpatient Colonoscopy
- Diagnostic Colonoscopy CPT/HCPCS
- Screening Colonoscopy CPT/HCPS
- Follow Up Colonoscopy CPT/HCPS
- Modifier Use in HOPPS for Incomplete Colonoscopy (Pro-fee Discussed After)
- Screening Colonoscopy Which Becomes Diagnostic
- Follow Up Screening Colonoscopy After Positive Non-Invasive Stool Based Colorectal Cancer Screening Test
- Ensure the Correct CPT Code For Polyp or Lesion Removals
- NCCI Manual Regarding Endoscopy
- Additional Documents
CEUs available for the following credentials:
AHIMA
CCA, CCS, CCS-P, RHIT, RHIA, CDIP, CHDA, CHPS
Key Takeaways
- Understanding of Colonoscopy Procedures: Participants will gain a thorough understanding of what a colonoscopy is, its purpose, and its significance in preventing and detecting colorectal cancer.
- Diagnosis Coding: Coders will learn how to appropriately assign diagnosis codes based on the nature of the colonoscopy, whether it is for screening, diagnosis, or treatment. This includes distinguishing between various clinical scenarios and conditions.
- CPT/HCPCS Procedure Codes: Participants will become proficient in selecting the correct Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes for different types of colonoscopies, including screening, diagnostic, and therapeutic procedures.
- Modifier Usage: The course covers the proper use of modifiers, such as -73 and -74, for incomplete colonoscopies and other scenarios where modifiers are necessary for accurate coding.
- High-Risk and Follow-Up Colonoscopies: Coders will learn how to code high-risk and follow-up colonoscopies accurately, considering factors like personal history of polyps and specific patient conditions.
- Compliance with Changing Guidelines: Given the evolving nature of healthcare regulations and guidelines, participants will be updated on the latest changes, such as those related to Medicare coverage policies and waiver of Part B deductibles.
- Polyp and Lesion Removal Coding: Coders will be equipped with the skills to select the appropriate CPT codes for the removal of polyps and lesions during colonoscopy procedures, taking into account the method used for removal.
- NCCI Guidelines: Participants will become familiar with National Correct Coding Initiative (NCCI) guidelines related to endoscopic services and understand how they apply to colonoscopy coding.
- Documentation Interpretation: The course will enhance participants' ability to interpret physician documentation accurately to ensure correct code assignment.
- Adherence to MAC and Payer Instructions: Coders will learn the importance of staying informed about and complying with Medicare Administrative Contractor (MAC) and payer instructions, as these can vary and impact coding decisions.
Benefits of Taking this Course
- Enhanced Coding Accuracy
- Improved Ability to Assign Correct Codes for Colonoscopies
- Career Advancement
- Increased Confidence
- Continuing Education
FAQs
What will I learn about coding screening versus diagnostic colonoscopies for outpatients?
This course explains how to distinguish between screening and diagnostic colonoscopies in the outpatient setting and how that distinction affects CPT and ICD-10-CM code assignment. You’ll learn how findings during a screening exam change coding, how intent is determined, and how to apply the correct codes based on provider documentation.
How does the course help coders apply modifier rules for outpatient colonoscopy procedures?
The course breaks down modifier use for outpatient colonoscopies, including when and how to apply modifiers for procedures that start as screening but become diagnostic. You’ll review real-world scenarios that show how modifier selection impacts reimbursement and compliance, helping you avoid common reporting errors.
Will this course improve my ability to identify documentation requirements for accurate outpatient colonoscopy coding?
Yes. The course highlights the key documentation elements coders must confirm, such as procedure intent, findings, biopsies or polyp removal, and whether the exam was completed. You’ll learn how to interpret operative reports and pathology results to ensure codes accurately reflect the services performed in outpatient encounters.
About Our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.
Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.
To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.
Disclaimer: This course is not for individual sale. Purchase an annual or monthly subscription below and get access to 200+ courses.
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