Avoid Medicare Screen Miscodes With This FAQ
Published on Thu Aug 20, 2009
Steer clear of G0121 denials by observing 10-year rule. If you slip up on screening colonoscopy claims' frequency guidelines and eligibility requirements, Medicare will pay you zilch. This colorectal cancer screening FAQ will provide you the coding ropes to start soaring through your coding duties with the greatest of ease. Q: Who's Eligible for Average-Risk Test? Any Medicare patient 50 years or older is eligible for a covered Medicare screening, confirms Dena Rumisek, CPC, biller at Michigan's Grand River Gastroenterology PC. Catch: These patients can have a colorectal cancer screening only once every 10 years, says Cheryl Ray, CCS, CPMA, of Atlantic Gastroenterology in Greenville, N.C. You'd be wise to pay attention to the frequency guidelines, as "Medicare is very stringent on the date ... it has to be 10 years or longer -- it can't be 9 years and 360 days" between covered screening colonoscopies, assures Rumisek. Example: A 73-year-old [...]