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99203 with v76.51

Myra Posted Fri 18th of November, 2011 19:59:03 PM

why do i keep on getting deniels when i bill a 99203 with a v76.51? Can anyone help me please

SuperCoder Answered Sun 20th of November, 2011 22:25:13 PM

It seems that the patient is being seen prior to a screening colonoscopy for which ICD V76.51 is used.
It is okay for a provider to bill an office visit prior to a colonoscopy, but Medicare (and others typically follow) states the "cost of the Office Visit is factored into the payment of the screening procedure".

But, if it is the office visit prior to first screening colonoscopy exam, then we can make an appeal, but not sure if it is going to be reimbursed.

Carol Answered Tue 10th of January, 2012 14:49:33 PM

I agree with Patrick. Medicare does NOT pay for a screening visit, however other insurances do. I would just add V7283 to the 99203 and you should get paid. We have been billing Medicare 99203 for follow up colonoscopies when the patient returns because of a personal hx of colonic polyps and have been getting paid.

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