Stefanie
Networker
Medicare Patient:
My GI doc has recently (this year) been recommending 1 year and sometimes 3-6 month colonoscopy follow-ups due to polyp pathology of high grade/low grade dysplasia. His operative report states "polypectomy" or "resection was complete." I feel like he knows something I don't, as far as new guidelines for surveillance. I wouldn't normally bill this follow-up colonoscopy as diagnostic, I'm not finding any new guidelines with USPSTF, or CMS' Colorectal Cancer Screening NCD changes. This follow-up isn't diagnostic because of the pathology result, is it? My fear is I'm going to advise to get an ABN because as of right now I will be coding it as surveillance, and the patient may choose not to get the follow-up due to cost. I guess I'm asking what would you do in this scenario?
Thank you!!
My GI doc has recently (this year) been recommending 1 year and sometimes 3-6 month colonoscopy follow-ups due to polyp pathology of high grade/low grade dysplasia. His operative report states "polypectomy" or "resection was complete." I feel like he knows something I don't, as far as new guidelines for surveillance. I wouldn't normally bill this follow-up colonoscopy as diagnostic, I'm not finding any new guidelines with USPSTF, or CMS' Colorectal Cancer Screening NCD changes. This follow-up isn't diagnostic because of the pathology result, is it? My fear is I'm going to advise to get an ABN because as of right now I will be coding it as surveillance, and the patient may choose not to get the follow-up due to cost. I guess I'm asking what would you do in this scenario?
Thank you!!