In CMS
May 5th, 2017
For Medicare beneficiaries in the office setting, if a provider preps a patient for a screening colonoscopy but cannot advance the scope past the splenic flexure due to obstruction, patient discomfort, or other complications, append modifier 53 Discontinued services to the appropriate code, per CMS Program Memorandum Transmittal AB-03-114, Change Request 2822. The Transmittal stresses, ...
In CMS
Sep 20th, 2016
by John Verhovshek, CPC, and Renee Dustman Reflecting United States Preventive Services Task Force (USPSTF) 2008 recommendations (2015 recommendations are in progress), Medicare Part B covers 100 percent of the Medicare-approved amount for fecal occult blood tests, flexible sigmoidoscopies, colonoscopies, and multi-target stool DNA tests, and 80 percent for barium enemas for colorectal cancer scr...
In Billing
Jan 7th, 2016
The Centers for Medicare & Medicaid Services (CMS) has established new values for incomplete diagnostic and screening colonoscopies performed on or after January 1, 2016. Why the Change? Prior to 2015, CPT® defined “incomplete colonoscopy” as a colonoscopy that did not evaluate the colon past the splenic flexure (the distal third of the colon). And ...
In Billing
May 18th, 2015
By Brad Ericson, MPC, CPC, COSC Federal officials clarified the rules on screening colonoscopies May 11 by telling providers not to charge patients for anesthesia provided during a screening colonoscopy.  The Department of Health and Human Services (HHS) made the declaration after patients complained of being charged hundreds of dollars for anesthesia while receiving the ...
March is National Colorectal Cancer Awareness month. Do your part by knowing the latest coding and billing guidelines. By Renee Dustman Fact No. 1: Colorectal cancer affects both men and women, and is the leading cause of cancer deaths in the United States. (Newly upgraded from second place.) Fact No. 2: Colorectal cancer is highly ...