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Diagnostic Colonoscopy vs. Screening Colonoscopy - Payer Defined

Presenter Terry A Fletcher, CPC, CCC, CEMC
Broadcast Date 8/26/2026
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
Diagnostic Colonoscopy vs. Screening Colonoscopy - Payer Defined Webinar

Learn more about this event

Learn Coding Techniques Through Workable Examples!

EGD, ERCP's with stent(s) placement and how to capture multiple stents. Upper GI endoscopy does it or does it not have a screening option? When coding multiple endoscopies, what are the best modifiers to use?

Screening vs. Diagnostic Colonoscopies have CPT® and payer definitions and we need to abide by them. Watch the wording in procedure reports to ensure you are capturing the correct CPT® code, such as bipolar cautery, heat probe, hot snare, snare, cold biopsy. This workshop will also, discuss how to report for Moderate Conscious Sedation vs. Monitored Sedation of Endoscopy procedures. Medicare has their own rules, and they will be discussed and referenced in the materials as well.

Learning Objectives

• Screening Colonoscopy vs. Diagnostic/Therapeutic Colonoscopy coding
• Understanding the patient share of cost timeline for Screening Colon Cancer Screening for patients
• When coding both an EGD and a Lower GI endoscopy, what are the reimbursement implications?
• Are different techniques and different locations of lesions billable under multiple endoscopy rules?
• ICD-10-CM links to endoscopy coding to mitigate denials as well as the controversial question will be answered: Can a pre-screening E/M visit be reported?

Why is this topic timely/important?

CMS and Medicare are changing the screening endoscopy rules for billing, coding and patient share of cost on a yearly basis. It is important that coders and medical administrative professionals are proactive in getting these updates to mitigate denials and/or reimbursement challenges.

Who would benefit from this topic?

Coders, Billers, Collectors, Billing managers, Gastro and Gen Surgery providers and their extenders.

Terry A Fletcher, CPC, CCC, CEMC

About The Author

Terry A Fletcher, CPC, CCC, CEMC

Terry A. Fletcher CPC, CCC, CEMC, CCS-P, CMC, CMSCS, ACS-CA, SCP-CA, QMGC, QMCRC, QMPM, PACS, CPA®-TH

Terry Fletcher is a 35+ year Healthcare Coding & Reimbursement Consultant, Educator and Auditor based in Southern California. Ms. Fletcher is a CPT and ICD-10-CM Coding Educator for AAPC, AHIMA, MedEd and NSCHBC. Terry has multiple certifications in coding, practice management and prior authorization.

Terry is a subject matter expert in CPT and ICD-10-CM coding, telehealth, regulatory guidance, reimbursement and compliance. Terry hosts a weekly award winning  CodeCast® podcast, the weekly #terrytuesday Compliance Podcast and the monthly NSCHBC Edge Podcast. 

 

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Two ways to register for this event
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