d.nelson0516
Contributor
Hello everyone,
I am looking for some advice on billing the initial visit prior to a screening colonoscopy. I have read the Medicare manual which states for minor procedures the pre-op visit is always included unless medically necessary (other issues). My understanding of this is that a colonoscopy is listed as a minor procedure and therefore any initial visit regardless if new or established patient would not be billable. Is this correct?
Would it be different if the pcp is referring them to us? Would that be considered the consultative visit instead? My provider thinks this may be different so i would like to get a clearer answer.
Thanks in advance!
I am looking for some advice on billing the initial visit prior to a screening colonoscopy. I have read the Medicare manual which states for minor procedures the pre-op visit is always included unless medically necessary (other issues). My understanding of this is that a colonoscopy is listed as a minor procedure and therefore any initial visit regardless if new or established patient would not be billable. Is this correct?
Would it be different if the pcp is referring them to us? Would that be considered the consultative visit instead? My provider thinks this may be different so i would like to get a clearer answer.
Thanks in advance!