Colonoscopy Consults

Greenpiper

Contributor
Messages
12
Location
Spokane, WA
Best answers
0
Help Please,

We are struggling with finding information regarding colonoscopy consults. We are aware CMS does not allow, however there is never any discussion around a consult not performed on the same day as the procedure. For example: Patients PCP deems it time for patient to have a colo screening so they refer them to one of our surgeons. Our surgeon then sees patient (asymptomatic), goes over prep instructions, gets signed consent and sends patient to schedule procedure. We are then getting a claim to code for colo consult with a level 4 (99214 w/dx Z12.11, Z86.010). Sometimes procedure is within the week, sometimes later i.e months. IS this appropriate to bill?Does it matter that procedure was not done on same day?

Any insight is greatly appreciated.
 

JanRebecca

Contributor
Messages
21
Best answers
0
No one seems to know??!! I used to bill for them and then was informed on this site that we could get audited and in trouble, so I stopped. Apparently that first visit is included with the global fee for colonoscopy.

UNLESS they are on blood thinner of some sort and need management for that - or if they have another issue at the same time other than just screening.
 

jaud63

Networker
Local Chapter Officer
Messages
79
Location
Inver Grove Heights, MN
Best answers
0
Patients should be able to schedule for a routine screening scope without a consult 1st. This is or can be part of a patients routine benefit? If a Consult is being performed what is the reason? Is the patient healthy?
 
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