Z492 and Z493 are eligible for payment for a colonoscopy rendered to a patient following a prior normal colonoscopy who has remained asymptomatic.
A colonoscopy is considered normal if there were either no polyps or only small (<1 cm) hyperplastic polyps present.
An exception to #1 above is a patient with hyperplastic polyposis syndrome who are at increased risk for adenomas and colorectal cancer and need to be identified for more intensive followup evaluation. See Z494.
A patient with sessile adenomas that may have only been partially removed or adenomatous polyps that are removed piecemeal should be considered for followup evaluation at short intervals (2–6 months) to verify complete removal. See Z491.]
Z492 is an uninsured service for the same patient in the five year period following Z499.