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Charge for colonscopy screening by RN

Kristen Posted Thu 25th of August, 2011 18:31:02 PM

Is there a way we can code for the nurse visit when patients come in to get set up for a colonoscopy? Our RN is spending at least 30 minutes with the patient going over medications, last colonoscopy; she gets their weight, vitals etc. The physician is not in the office but he is in the hospital. Is there a code we can use to charge for her services?

SuperCoder Answered Fri 26th of August, 2011 19:49:58 PM

Mostly pre-colonoscopy evaluation by nurses are included in the procedure and can not be billed separately. These normally spans from 10 to 15 minutes. It is often difficult to justify the medical necessity for a 30-minute evaluation by the nurse. I would like to cite the norms that are followed in these circumstances:-
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In some precolonoscopy screening visits, the nurses in consultation with the physicians just schedule the colonoscopy, faxing the checklist to the patient’s primary-care physician and asking him to go over it with the patient.
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In some other cases, they conduct group precolonoscopy screenings, then schedule E/M visits only for patients who require them. Group screenings involve a nurse practitioner (NP) or physician assistant (PA) conducting a session with 10 to 15 precolonoscopy screening patients. When the patient reports for the session, present him with your office’s checklist and have him fill it out.
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If there’s anything on the checklist that draws attention, then the patient is scheduled to see the physician before the colonoscopy.
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Example:
If in an ambulatory surgical center, a nurse takes the patient’s history and the gastroenterologist reviews it with the patient before he or she is sedated, then we shouldn't bill for that. It’s included in the procedure, and it would be fraudulent if we tried to bill for that.

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