Wiki Indications and findings on EGD or Colons

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Nelsen

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Does anyone know where I can find information on Medicare's website on billing procedures for indications and findings? We belong to Novitas Medicare and I can not find anything on their website.

Thank you in advance.
 
abogari cpc

I'm not exactly sure what you are looking for. The rules for coding screening vs diagnostic? My doc is a general surgeon who performs both of these frequently and we are part of Novitas as well. Can you provide an example?
 
We had a patient who had an EGD done for heme positive stools (diagnosis code 792.1), which is not a covered diagnosis for an EGD by Medicare. our billing department will not appeal medicare because they state we can not appeal off the findings only the indications and we didn't get an ABN on this patient. I thought that we could appeal off of findings too, but can not find anywhere in Novitas's website that we can.
 
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