Coding FAQ - Screening Colonoscopy

With thanks to Kathy Mueller and Betsy Nicoletti. Coding for Screening Colonoscopies, Betsy Nicoletti With permission from Ms. Nicoletti.

A screening test is a test provided to a patient in the absence of signs or symptoms. A screening colonoscopy is a service performed on an asymptomatic person for the purpose of testing for the presence of colorectal cancer or colorectal polyps. Whether a polyp or cancer is ultimately found does not change the screening intent of that procedure. As part of the Affordable Care Act (ACA), Medicare and most third-party payors are required to cover services given an A or B rating by the U.S. Preventive Services Task Force (USPSTF) without a co-pay or deductible.  

Diagnostic colonoscopy is a test performed as a result of an abnormal finding, sign or symptom (such as abdominal pain, bleeding, diarrhea, etc.). Medicare and most payors do not waive the co-pay and deductible when the intent of the visit is to perform a diagnostic 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]).  

For Medicare beneficiaries, use Healthcare Common Procedural Coding System (HCPCS) code G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) or G0121 (Colorectal cancer screening; colonoscopy on individual not meeting the criteria for high risk) as appropriate. CMS developed the HCPCS codes to differentiate between screening and diagnostic colonoscopies in the Medicare population.

Common diagnosis codes for colorectal cancer screening include: 

V76.51 (Special screening for malignant neoplasms of colon).

V16.0 (Family history of malignant neoplasm of gastrointestinal tract).

V12.72 (Personal history of colonic polyps).  

If a polyp is found, some Medicare contractors require 211.3 (Benign neoplasm, colon) in the first line of the claim.

Medicare beneficiaries without high risk factors are eligible for screening colonoscopy every 10 years. Beneficiaries at high risk for developing colorectal cancer are eligible once every 24 months. Medicare considers an individual at high risk for developing colorectal cancer as one who has one or more of the following:

A close relative (sibling, parent or child) who has had colorectal cancer or an adenomatous polyp.

A family history of familial adenomatous polyposis.

A family history of hereditary nonpolyposis colorectal cancer.

A personal history of adenomatous polyps.

A personal history of colorectal cancer.

Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis.

To report screening colonoscopy on a patient not considered high risk for colorectal cancer, use HCPCS code G0121 and diagnosis code V76.51 (Special screening for malignant neoplasm of the colon). 

To report screening on a Medicare beneficiary at high risk for colorectal cancer, use HCPCS G0105 and the appropriate diagnosis code that necessitates the more frequent screening.

It is not uncommon to remove one or more polyps at the time of a screening colonoscopy. Because the procedure was initiated as a screening, the screening diagnosis is primary and the polyp(s) is secondary. The endoscopist reports the appropriate code for the diagnostic or therapeutic procedure performed, e.g. CPT code 45379—45392.   

CMS developed the PT modifier to indicate that a colonoscopy that was scheduled as a screening was converted to a diagnostic or therapeutic procedure. The PT modifier (Colorectal cancer screening test, converted to diagnostic test or other procedure) is appended to the CPT code. 

CPT developed modifier 33 for preventive services, “when the primary purpose of the service is the delivery of an evidence-based service in accordance with a U.S. Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure.” 

For example, if a physician performing a screening colonoscopy finds and removes a polyp with a snare, use CPT code 45385 and append modifier 33 to the CPT code.

When the intent of a visit is screening, and findings result in a diagnostic or therapeutic service, the ordering of the diagnosis codes can affect how payors process the claim. There is considerable variation in how payors process claims, and the order of the diagnosis code may affect whether the patient has out-of-pocket expenses for the procedure. The appropriate screening diagnosis code should be placed in the first position of the claim form and the finding or condition diagnosis in the second position. It is important to verify a payor’s reporting preference to avoid payment denials.

Here are some examples for screening colonoscopy, which applies to both the physician and outpatient facility. Claims should be coded the same for procedures, modifiers and diagnosis with the exception of the discontinued procedure modifier (when the physician uses modifier 53, the outpatient hospital/ambulatory surgical facility uses modifier 74).
 
Example #1
Indication: Colon screening
Post-endoscopy finding: Normal colonic mucosa
Procedure code: G0121 (Average risk screening) or 45378-33 (Diagnostic colonoscopy with modifier 33 indicating this is a preventive service).
Diagnosis code: V76.51 (Special screening for malignant neoplasms, colon)
 
Example #2
Indication: Personal history of colon polyps, Colon screening
Post-endoscopy findings: Normal colonoscopy
Procedure code: G0105 (High risk screening) or 45378-33 (Diagnostic colonoscopy with modifier 33 indicating this is a preventive service)
Diagnosis code: V12.72 (Personal history of colon polyps)
 
Example #3
Indication: Colon screening
Post-endoscopy findings: Polyps in the cecum and sigmoid colon
Procedure: Colonoscopy with removal of cecal and sigmoid polyps by snare technique
Procedure code: 45385 (Colonoscopy with removal of polyp by snare)
Modifier PT (if Medicare patient) or Modifier 33 (if non-Medicare) should be added to indicate this was a preventive service and to trigger benefits
Diagnosis code: V76.51 (Special screening for malignant neoplasms, colon). Some Medicare payors instruct to only use the finding since the PT modifier indicates it was done for screening.
211.3 (Benign neoplasm, colon [based on pathology report])
 
Example #4 
Indication: Personal history of colon polyps; Colon screening
Post-endoscopy findings: Large sessile polyp in the rectum, unable to resect, pending pathology
Procedure: Colonoscopy with biopsy of rectal polyp. Will await pathology and consider surgical referral.
Procedure code: 45380 (Colonoscopy with biopsy
Modifier PT (if Medicare) or Modifier 33 (non-Medicare) should be added to indicate this was a preventive service and to trigger preventive 
Diagnosis code: V12.72 (Personal history of colon polyps). Some Medicare payors [First Coast and Noridian] instruct to only use the finding since the PT modifier indicates it was done for screening.
211.4 (Benign neoplasm, rectum) or 235.2 (Neoplasm uncertain behavior, intestines and rectum [based on pathology report]).
 
Example #5
Indication: Change in bowel habits, here for colon screening
Post-endoscopy findings: Normal colon
Procedure: Colonoscopy
Procedure code: 45378  
Do not append modifier 33 or PT, as this service was performed for a diagnostic, not screening, indication.

Yes. If the patient requires some intervention on the part of the gastroenterologist prior to the procedure, you can bill a New Patient or Established Patient visit, depending on whether the patient has received any face-to-face service by any provider of the same specialty in your office within the last three years.

No. Per Medicare guidelines, the procedure should be codes as a colonoscopy with a 53 modifier, which will pay a partial fee and allow you to repeat the procedure within the restricted time period and get full payment for the second procedure. Even if the scope was advanced beyond the splenic flexure, but the visualization was poor and the physician wants to repeat the procedure within the restricted time period, add the 53 modifier.

For all payors, if the procedure was initiated as a screening, the screening diagnosis is primary and the polyp is secondary. For example, on form CMS-1500 in the line with the polypectomy procedure code, in Box 24E (the diagnostic pointer box) enter a “2” linking the procedure with the polyp. In this way, the patient will receive the insurance benefits associated with screening procedures and the service will be paid correctly.  

Given Medicare’s time restriction of two years between two high risk screenings and 10 years between two average risk procedures, if a screening is repeated in one year, it will be denied by Medicare as “not medically necessary.” If the physician wants to repeat the procedure within the restricted time, the first procedure should be billed with a 53 modifier, even though the scope advanced beyond the splenic flexure.

Effective Jan. 1, 2011, if a patient presents for a screening colonoscopy or flexible sigmoidoscopy (no GI symptoms), Medicare will waive both the deductible and coinsurance when billing the G codes for the screening. 

If a polyp or lesion is found during the screening procedure, the colonoscopy becomes diagnostic and should be reported with the appropriate diagnostic colonoscopy code (45378-45392). For Medicare patients, the PT modifier would be appended to the code to indicate that this procedure began as a screening test. Medicare will still waive the deductible, but the patient will be responsible for the coinsurance.

Coding FAQ - Screening Colonoscopy

We’ve compiled answers to common coding questions many practices have for colorectal cancer (CRC) screening, by colonoscopy as well as stool-based tests. We also have a guide for patients on what to expect when paying for their CRC screening.

Coding guide for CRC screening: Unlocking the free screening benefit for your patients

New policies are making colorectal cancer (CRC) screening free to more people and eliminating surprise bills, but only if doctors and facilities submit the correct procedure and diagnosis codes. This guide will identify the correct codes and show you how to help patients who get an unexpected bill after undergoing a colorectal cancer screening.

Here are the most common CRC screening tests, how to code for them, and what patients with commercial insurance and Original Medicare can usually expect to pay depending on whether they have commercial insurance or Medicare. (Note: Rules for Medicaid vary by state. Commercial plans in place on or before March 23, 2010, and employer-sponsored health care plan are not required to follow the rules below.)

Procedure codes

Commercial insurance:

  • 45378 – Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

Medicare:

  • G0121 – Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk, or
  • G0105 – Colorectal cancer screening; colonoscopy on individual at high risk

ICD-10-CM codes

  • Z12.11 – encounter for screening for malignant neoplasm of colon (Note: this code must be listed first when reporting multiple diagnosis codes)
  • Z12.12 – encounter for screening for malignant neoplasm of rectum (Note: this code must be listed first when reporting multiple diagnosis codes)
  • Z80.0 – family history of malignant neoplasm of digestive organs
  • Z83.71 – family history of colonic polyps
  • Z85.038 – personal history of other malignant neoplasm of large intestine
  • Z85.048 – personal history of other malignant lesion of rectum, rectosigmoid junction and anus
  • Z86.010 – personal history of colonic polyps

Insurance coverage

Commercial insurance:

  • Colonoscopy, bowel prep, sedation, lab work and the hospital or ambulatory surgery center costs where the colonoscopy was performed are covered 100% by health insurance.

Medicare:

  • Colonoscopy and sedation are covered 100% when no polyps are found.

Procedure codes for commercial insurance and Medicare:

Select the appropriate code based on the type of removal performed. If multiple polyps/lesions were removed using different techniques, report each method separately. NOTE: You must add modifier 33 or PT (see below) to identify the polypectomy as a screening service and prevent the patient from being inappropriately billed.

  • 45380 – Colonoscopy, flexible; with biopsy, single or multiple
  • 45384 – Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
  • 45385 – Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
  • 45388 – Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
    • Add modifier 33 (preventative services) to each CPT code for commercial insurance
    • Add modifier PT (colorectal cancer screening test; converted to diagnostic test or other procedure) to each CPT code for Medicare

ICD-10-CM codes

  • Z12.11 – encounter for screening for malignant neoplasm of the colon (Note: this code must be listed first when reporting multiple diagnosis codes)
  • Z12.12 – encounter for screening for malignant neoplasm of rectum (Note: this code must be listed first when reporting multiple diagnosis codes)
  • D12.0 – benign neoplasm of the cecum
  • D12.4 – benign neoplasm of the descending colon
  • D12.8 – benign neoplasm of the rectum

Insurance coverage

Commercial insurance:

  • Colonoscopy, bowel prep, sedation, lab work and the hospital or ambulatory surgery center costs where the colonoscopy with polypectomy was performed are covered 100% by health insurance.

Medicare:

  • In 2022, if a polyp is removed the patient is responsible for 20% of the cost. From 2023 to 2026, patient responsibility is 15% of the cost, from 2027 to 2029 it falls to 10% and by 2030 it will be covered 100% by Medicare.

Procedure codes:

Select the appropriate code based on the type of test performed.

Commercial insurance:

  • FIT: 82274 – Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations
  • FOBT: 82270 – Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)
  • Multi-target stool DNA test: 81528 – Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 DNA markers (KRAS mutations, promoter methylation of NDRG4 and BMP3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result

Medicare:

  • FIT: G0328 – Colorectal Cancer Screening; Immunoassay, Fecal-Occult Blood Test, 1-3 Simultaneous Determinations
  • FOBT: G0107 – Colorectal Cancer Screening; Fecal-Occult Blood Test, 1-3 Simultaneous Determinations
  • Multi-target stool DNA test: G0464 – Colorectal cancer screening; stool-based DNA and fecal occult hemoglobin (e.g., KRAS, NDRG4 and BMP3)

ICD-10-CM codes

  • Z12.10 – encounter for screening for malignant neoplasm of intestinal tract, unspecified
  • Z12.11 – encounter for screening for malignant neoplasm of colon
  • Z12.12 – encounter for screening for malignant neoplasm of rectum

Insurance coverage

Commercial insurance:

  • Pays for both the stool-based test and colonoscopy (including polyp removal) after a positive stool test if it was done after May 31, 2022. For tests performed before May 31, 2022, the stool-based test is covered at 100%, but patients might have to pay some of the costs for the colonoscopy.

Medicare:

  • Pays for the stool-based test at no cost, but patients may have to pay some of the cost of the colonoscopy if they have a positive test result.

For a colonoscopy following a positive stool-based test

  • Ask your patient if their plan was created on or before March 23, 2010, or if they have an employer-sponsored health care plan. These plans are not required to provide all the benefits and protections of the Affordable Care Act and are not required to cover colonoscopy following a positive stool-based test.
  • Contact the insurance company and ask why the colonoscopy claim was denied.
  • Inform the claims representative of guidance from the U.S. Department of Labor (DOL) that health plans and insurers “must cover and may not impose cost sharing with respect to a colonoscopy conducted after a positive non-invasive stool-based screening test” for plan or policy years beginning on or after May 31, 2022. See questions 6 (page 9) and 7 (page 12) of the DOL FAQ About Affordable Care Act Implementation

For a screening colonoscopy when a polyp was removed

  • Ask your patient if their plan was created on or before March 23, 2010, or if they have an employer-sponsored health care plan. These plans are not required to provide all the benefits and protections of the Affordable Care Act and are not required to cover colonoscopy following a positive stool-based test.
  • Contact the insurance company and ask why the colonoscopy claim was denied.
  • Inform the claims representative of guidance from the U.S. Department of Health and Human Services (HHS) that “the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure.” See question 5 of the HHS Affordable Care Act Implementation FAQs

What is a screening colonoscopy and how to report it

A screening test is a test provided to a patient in the absence of signs or symptoms. A screening colonoscopy is a service performed on an asymptomatic person for the purpose of testing for the presence of colorectal cancer or colorectal polyps. Whether a polyp or cancer is ultimately found does not change the screening intent of that procedure. As part of the Affordable Care Act (ACA), Medicare and most third-party payors are required to cover services given an A or B rating by the U.S. Preventive Services Task Force (USPSTF) without a co-pay or deductible, but the correct CPT and ICD-10-CM codes must be submitted to trigger coverage at 100% for the patient. See the AGA coding guide for CRC screening above to learn what codes to use and know what patients can usually expect to pay depending on whether they have commercial insurance or Original Medicare.

Diagnostic colonoscopy is a test performed as a result of an abnormal finding, sign or symptom (such as abdominal pain, bleeding, diarrhea, etc.). Medicare and most commercial payors do not waive the co-pay and deductible when the intent of the visit is to perform a diagnostic 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]). However, if polyps are removed use the appropriate CPT code below based on the removal technique:

  • 45380 – Colonoscopy, flexible; with biopsy, single or multiple
  • 45384 – Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
  • 45385 – Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
  • 45388 – Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)

Add modifier 33 to each CPT code submitted on the claim. If modifier 33 is not added, the colonoscopy will not be recognized as a screening service and the patient will be inappropriately billed.

For Medicare beneficiaries, use Healthcare Common Procedural Coding System (HCPCS) code G0105 (Colorectal cancer screening; colonoscopy on individual at high risk) or G0121 (Colorectal cancer screening; colonoscopy on individual not meeting the criteria for high risk) as appropriate. CMS developed the HCPCS codes to differentiate between screening and diagnostic colonoscopies in the Medicare population. If polyps are removed, use the appropriate CPT code listed above and add modifier PT (colorectal cancer screening test; converted to diagnostic test or other procedure) to each CPT code for Medicare. If modifier PT is not added to the CPT code submitted on the Medicare claim, the colonoscopy with polypectomy will not be recognized as a screening service and the patient will be inappropriately billed.

See the AGA coding guide for CRC screening for more information.

Medicare beneficiaries without high risk factors are eligible for screening colonoscopy every 10 years. Beneficiaries at high risk for developing colorectal cancer are eligible once every 24 months. Medicare considers an individual at high risk for developing colorectal cancer as one who has one or more of the following:

  • A close relative (sibling, parent or child) who has had colorectal cancer or an adenomatous polyp.
  • A family history of familial adenomatous polyposis.
  • A family history of hereditary nonpolyposis colorectal cancer.
  • A personal history of adenomatous polyps.
  • A personal history of colorectal cancer.
  • Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis.

To report screening colonoscopy on a patient not considered high risk for colorectal cancer, use HCPCS code G0121 and diagnosis code V76.51 (Special screening for malignant neoplasm of the colon).

To report screening on a Medicare beneficiary at high risk for colorectal cancer, use HCPCS G0105 and the appropriate diagnosis code that necessitates the more frequent screening.

Here are some examples for screening colonoscopy, which applies to both the physician and outpatient facility. Claims should be coded the same for procedures, modifiers and diagnosis with the exception of the discontinued procedure modifier (when the physician uses modifier 53, the outpatient hospital/ambulatory surgical facility uses modifier 74).

Example #1
Indication: Colon screening
Post-endoscopy finding: Normal colonic mucosa
Procedure code: G0121 (Average risk screening) for Medicare or 45378-33 (Diagnostic colonoscopy with modifier 33 indicating this is a preventive service) for commercial insurance
Diagnosis code: V76.51 (Special screening for malignant neoplasms, colon)

Example #2
Indication: Personal history of colon polyps, Colon screening
Post-endoscopy findings: Normal colonoscopy
Procedure code: G0105 (High risk screening) for Medicare or 45378-33 (Diagnostic colonoscopy with modifier 33 indicating this is a preventive service) for commercial insurance
Diagnosis code: V12.72 (Personal history of colon polyps)

Example #3
Indication: Colon screening
Post-endoscopy findings: Polyps in the cecum and sigmoid colon
Procedure: Colonoscopy with removal of cecal and sigmoid polyps by snare technique
Procedure code: 45385 (Colonoscopy with removal of polyp by snare)
Modifier PT (if Medicare patient) or Modifier 33 (if non-Medicare) should be added to indicate this was a preventive service and to trigger CRC screening benefits
Diagnosis code: V76.51 (Special screening for malignant neoplasms, colon). Some Medicare payors instruct to only use the finding since the PT modifier indicates it was done for screening.
211.3 (Benign neoplasm, colon [based on pathology report])

Example #4
Indication: Personal history of colon polyps; Colon screening
Post-endoscopy findings: Large sessile polyp in the rectum, unable to resect, pending pathology
Procedure: Colonoscopy with biopsy of rectal polyp. Will await pathology and consider surgical referral.
Procedure code: 45380 (Colonoscopy with biopsy)
Modifier PT (if Medicare) or Modifier 33 (non-Medicare) should be added to indicate this was a preventive service and to trigger CRC screening benefits
Diagnosis code: V12.72 (Personal history of colon polyps). Some Medicare payors [e.g., First Coast and Noridian] instruct to only use the finding since the PT modifier indicates it was done for screening so check with the patient’s insurance for payor-specific rules.
211.4 (Benign neoplasm, rectum) or 235.2 (Neoplasm uncertain behavior, intestines and rectum [based on pathology report]).

Example #5
Indication: Change in bowel habits, presenting for colon screening
Post-endoscopy findings: Normal colon
Procedure: Colonoscopy
Procedure code: 45378
Do not append modifier 33 or PT, as this service was performed for a diagnostic, not screening, indication.

How to report screening colonoscopy that becomes therapeutic

It is not uncommon to remove one or more polyps at the time of a screening colonoscopy. Because the procedure was initiated as a screening, the screening diagnosis is primary and the polyp(s) is secondary. The endoscopist reports the appropriate code for the diagnostic or therapeutic procedure performed, e.g. CPT code 45379—45392.

CMS developed the PT modifier to indicate that a colonoscopy that was scheduled as a screening was converted to a diagnostic or therapeutic procedure. The PT modifier (Colorectal cancer screening test, converted to diagnostic test or other procedure) is appended to the CPT procedure code for Medicare claims.

CPT developed modifier 33 for preventive services, “when the primary purpose of the service is the delivery of an evidence-based service in accordance with a U.S. Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure.” Modifier -33 is used for commercial insurance claims.

For example, if a physician performing a screening colonoscopy on a patient with commercial insurance finds and removes a polyp with a snare, use CPT code 45385 and append modifier 33 to the CPT code. If the patient is a Medicare beneficiary, use CPT code 45385 with modifier PT.

When the intent of a visit is screening, and findings result in a diagnostic or therapeutic service, the ordering of the diagnosis codes can affect how payors process the claim. There is considerable variation in how payors process claims, and the order of the diagnosis code may affect whether the patient has out-of-pocket expenses for the procedure. The appropriate screening diagnosis code should be placed in the first position of the claim form and the finding or condition diagnosis in the second position. It is important to verify a payor’s reporting preference to avoid payment denials.

See the AGA coding guide for CRC screening for more information.

If a polyp or lesion is found during the screening procedure, the colonoscopy should be reported with the appropriate diagnostic colonoscopy code (45378-45392) based on the procedure performed. For Medicare patients, add PT modifier to the code to indicate that this procedure began as a screening test. For patients with commercial insurance, add modifier -33.

Complex cases

Yes. If the patient requires some intervention on the part of the gastroenterologist prior to the procedure, you can bill a New Patient or Established Patient visit, depending on whether the patient has received any face-to-face service by any provider of the same specialty in your office within the last three years.

No. Per Medicare guidelines, the procedure should be codes as a colonoscopy with a 53 modifier, which will pay a partial fee and allow you to repeat the procedure within the restricted time period and get full payment for the second procedure. Even if the scope was advanced beyond the splenic flexure, but the visualization was poor and the physician wants to repeat the procedure within the restricted time period, add the 53 modifier.

Yes. The time restrictions only apply between two screenings if the patient has no symptoms. Medicare does require cost-sharing for diagnostic colonoscopy and will be responsible for a portion of the bill.

Given Medicare’s time restriction of two years between two high risk screenings and 10 years between two average risk procedures, if a screening is repeated in one year, it will be denied by Medicare as “not medically necessary.” If the physician wants to repeat the procedure within the restricted time, the first procedure should be billed with a 53 modifier, even though the scope advanced beyond the splenic flexure.

With thanks to Kathy Mueller and Betsy Nicoletti.

Coding for Screening Colonoscopies, Betsy Nicoletti
With permission from Ms. Nicoletti.