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Wiki Screening Colonoscopy Billing to Medicare Secondary

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cedwards

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Branford, CT
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We are billing the patient's primary insurance 45378 with V76.51 for a screening colonoscopy.

The primary made payment but patient still has a coinsurance which we are billing to Medicare.

Medicare is secondary and denied the claim These are non-covered services because this is not deemed a `medical necessity' by the payer.

How would you handle this?

Are you billing all screenings with G0121 or G0105 to all payers?
 
screening colonoscopy

Not sure what state you are in but most states have a LCD on file for this jprocedure you just have to make sure all the coverage guidelines are met for a screening for ex. age and bill the G code...
 
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