A Medicare patient with a personal history of polyps comes in, removed a polyp (2 polyps)coming back in 3-5 years
Report states this is a surveillance ( last colon 3 years ago, removed polyp)
If we follow Medicare guidelines, Medicare pays for a screening colon due to personal history of polyps every 24 months. How can we code for a screening when the doctor refuses to put screening and always has report as a surveillance? Shouldn't we be coding 45385 PT Modifier w/ Z860.10 as primary dx and D12.0, D12.6. If we code as surveillance, the patients deductible applies as well as their coinsurance. If its a screening, deductible is waived. I feel these patients should not be billed for deductibles since Medicare guidelines states they are allowed 1 screening every 24 months.
Can I get some else's opinion?
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