• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Colon Cancer Screening Guidelines

O

oceangirl752002

Contributor
Messages
20
Location
Mooresville, NC
How specific are the guidelines for screening? I know it's every 10 years, but is it exact date to exact date (1.1.08 - 1.1.18) or just by calendar year? I had a pt come in for a screening on 2/6/18 and previous was 12/29/08 which technically is less than 10 years. Any thoughts/clarification is appreciated.
 
For a ten-year interval, I don't think it's anything you need to worry about. Does the patient still have the same insurance policy or coverage that they did in 2008? Even if they do, I don't know of any payers that retain 10 years of claims data in their systems, so I would be extremely surprised if you received a denial for the services being less than exactly ten years apart. If the provider feels that it's appropriate to do the screening at 9 years and 2 months instead of 10 years, I wouldn't be concerned.
 
Last edited:
We always try to make it 10 years plus 1 day, just to be on the safe side. Medicare is the only payer I know of that is very strict about that. If the patient comes in sooner than the 10 year mark and they are average risk, even if Medicare did not pay for the one almost 10 years ago, we have had them deny it.
 
You must log in or register to reply here.
Top