Wiki Teaching Attestations for Colonoscopies/Endoscopy

[jomartinez]

Medicare states in the Medicare Claims Processing Manual under Chapter 12 100.1.2.A.5

5. Endoscopy Procedures
To bill Medicare for endoscopic procedures (excluding endoscopic surgery that follows the surgery policy in subsection A, above), the teaching physician must be present during the entire viewing. The entire viewing starts at the time of insertion of the endoscope and ends at the time of removal of the endoscope. Viewing of the entire procedure through a monitor in another room does not meet the teaching physician presence requirement.

Question: Does the Teaching Attestation need to be present from insertion of the endoscope for Medicare patients only or are all other 3rd Party payers following the Medicare guideline even though the manual specifically states to bill Medicare? Are you following the Medicare guideline for all payers across the board or only for Medicare patients?

Thank you

 

[pedscoder21]

Hi there,

This is Medicare's rule, however, many commercial insurers follow Medicare guidance. Our facility follows Medicare's guidelines across the board. You can always contact a specific payer to determine their rules.