Office Visits prior to Screening Colon

rcclary

Networker
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64
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I know you cannot charge for an E/M visit for a screening colonoscopy with Medicare but what about other carriers. I am wanting to see what other offices are doing in this instance. I know some carriers will deny the claim for inconsistent coding. You cannot put a V code with an problematic E/M visit (e.g. V76.51 w/ 99203). BCBS will deny the claim but to the patient's responsibility stating preventative office visits are not covered. I would like to hear how other offices are handling the office visits prior to screening colonoscopies. Do you charge for them? Thanks for your help.
 

MnTwins29

True Blue
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East Greenbush, NY
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Clarification

Is this the visit for the procedure itself or is this for a visit on a day prior to the visit? If the latter, what about a pre-op clearance or maybe addressing a S/S that while itself not the reason for a colonoscopy, the procedure is desired because of the S/S and other factors, such as age or family history? Just trying to get some clarification on what you are asking.
 

JJackson506

Guest
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I know you cannot charge for an E/M visit for a screening colonoscopy with Medicare but what about other carriers. I am wanting to see what other offices are doing in this instance. I know some carriers will deny the claim for inconsistent coding. You cannot put a V code with an problematic E/M visit (e.g. V76.51 w/ 99203). BCBS will deny the claim but to the patient's responsibility stating preventative office visits are not covered. I would like to hear how other offices are handling the office visits prior to screening colonoscopies. Do you charge for them? Thanks for your help.
For non-Medicare patients you can see the patient prior to a colonoscopy in the office and charge for an E/M service. If the patient is sent to your doctor in consult you use a consult code and the appropriate ICD-9 code.
 
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