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Gastroenterology Coding Alert

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Abstain From E/M Codes for Visits Prior to Screening Colonoscopies

Published on Wed Sep 12, 2012

Question: We have a new gastroenterologist in our practice and he wants to see the patients (that are coming for a screening colonoscopy) prior to performing the procedure which he will schedule for later. Can I charge for this visit? He is of the opinion that the preliminary visit can be charged but I am not too sure whether this is right.Maryland SubscriberAnswer: Any routine pre-procedure evaluation and management service that is provided immediately (same day) before your gastroenterologist undertakes a screening colonoscopy will not be paid for by Medicare and will usually be denied by commercial carriers. If the patient seeks an appointment prior to scheduling a screening colonoscopy or is referred to by another physician requesting a screening colonoscopy, you may not want to bill any E/M codes for the encounter. This policy of a bundled routine E/M visit is specifically defined by Medicare, and some other commercial [...]
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