Don't Miss 0067T Coverage Opportunity
Question: Washington Subscriber Be sure to tie 0067T to the appropriate diagnosis code for the patient, such as 578.1 ( Currently, payers won't cover routine screening CT colonography but may consider it medically necessary when conventional colonoscopy fails for patients with colon disease signs and symptoms. The payer may also want to see evidence that the colonography is likely to affect patient management. The ABN instructs the patient that you suspect Medicare won't pay for the service, and the patient must choose whether he is willing to receive the service knowing he may have to pay. The ABN should include an estimate of the cost, and you should have the patient sign and date the document. You should append modifier GA (
Experts warn: Don't obtain "blanket" ABN forms from all or most of your patients. You should obtain ABNs only when your practice has ample reason to believe that Medicare will deny the claim.
