Gastroenterology Coding Alert

Following 10-year-rule eliminates G0121 rejection.If you slip up on screening colonoscopy claims' frequency guidelines and eligibility requirements, Medicare will pay you zilch. Use this guidance to capture every screening dollar your gastroenterologist deserves.Home in on Eligibility Requirements for Average-Risk TestAny Medicare patient 50 years or older is eligible for a covered Medicare screening, explains Dena Rumisek, CPC, biller at Grand River Gastroenterology PC in Michigan. These patients can have a colorectal cancer screening only once every 10 years. 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, Remise warns.Example: A 73-year-old established Medicare patient with average risk for colorectal cancer reports for a screening colonoscopy on Feb. 11, 2009. The patient's records indicate that he last had a covered [...]