March 15, 2018

Question:
Is a colonoscopy coded by how far you can visualize or the end point of the scope?

Answer:
Per CPT, a colonoscopy is reported based on how far the scope is advanced; the end of the scope.  If the scope cannot be advanced past the splenic flexure, report a sigmoidoscopy.  If the scope is advanced past the splenic flexure but not all the way to the cecum, report a colonoscopy code with a modifier; modifier 53 if it is a diagnostic or screening colonoscopy, modifier 52 if it is a therapeutic colonoscopy.

*This response is based on the best information available as of 03/15/18.