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Max Benefits

Shamae Posted Mon 25th of November, 2013 17:02:44 PM

On some of our Medicare patients we'll recieve Max Benefits for this time period has been reached with the code of G0121, then we're to write off procedure. Is there something i can do to recieve payments for these claims?

SuperCoder Answered Mon 25th of November, 2013 18:06:23 PM

Medicare beneficiaries without high risk factors are eligible for screening colonoscopy every 10 years. Those with high risk are eligible once every 24 months. With G0121 use ICD-9 code V76.51. If patients want one more than once every 10 years and they are without risk factors, have them sign an Advanced Beneficiary Notice [ABN]. And bill the patient.

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