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Medicare Colonoscopy

kernodle Posted Tue 05th of June, 2012 13:16:17 PM

Patient presented to GI for colonoscopy with a history of colon polyps. Patient was examined, an interval history was obtained and procedure reviewed. Patient declined to schedule colonoscopy at this time but may reconsider. Provider explained the risks of refusing colorectal cancer screening. I say this visit is billable since the screening colonoscopy was not scheduled. Looking for a second opinion.

Deb Hughes

SuperCoder Answered Tue 05th of June, 2012 20:22:36 PM

A visit prior to a screening colonoscopy for a healthy patient is not billable.

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.

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