AAPC - Back to school
Results 1 to 5 of 5

Thread: Initial visit with surgeon for Screening Colonoscopy

  1. #1
    Join Date
    Apr 2007

    Default Initial visit with surgeon for Screening Colonoscopy

    AAPC: Back to School
    What would the proper way to bill a patient for an initial visit with the general surgeon if they are presenting as a referral for a screening Colonoscopy? We are getting denials from Medicare for the initial visit with the V76.51 code.. any suggestions? or do we need to be collecting up front for the visit?

  2. #2


    That is right. But may be they need a difinite primary first listed ; may be E/M service new patient / established ?!

  3. #3
    Join Date
    Apr 2007
    Fayetteville, NC


    If the only reason that the patient came to the office is for the set-up for the screening colon then you have no choice but to bill the V76.51. Medicare does not pay for the set-up visit when there are no indications (symptoms) and per Medicare you can bill the patient for this.
    I work for surgeons and we have struggled with this issue as well. Unfortunately for a screening set-up there is no easy answer
    Your office may want to start informing the patients who are there for screening colon set-ups that the visit will not be paid by Medicare and will be their responsibility.....

  4. #4
    Join Date
    Apr 2007


    Thanks for the clarification on this!

  5. #5
    Join Date
    Apr 2007


    We try to screen the appointments for this information. If they say it's for a screening we advise them right away that the visit isn't covered and then when they come in we have them sign an ABN for medicare patients. It had been an issue at our office before and the only reason we were able to bill the patient was because of the ABN. The patient called Medicare and complained about us and when Medicare called me, I explained we had an ABN, I faxed it to them and the patient paid the bill.

Similar Threads

  1. visit for screening colonoscopy no symptoms.
    By kbarron in forum Gastroenterology
    Replies: 4
    Last Post: 05-11-2016, 12:34 PM
  2. E/M visit prior to screening colonoscopy
    By ashive7431 in forum E/M
    Replies: 2
    Last Post: 02-05-2014, 09:28 AM
  3. Visit before Screening Colonoscopy
    By MichelleCPC in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 01-03-2011, 12:10 PM
  4. Pre screening colonoscopy visit
    By molisa in forum Gastroenterology
    Replies: 0
    Last Post: 08-18-2010, 08:12 AM
  5. Visit prior to a screening colonoscopy
    By BPinchbeck in forum Medicare Regulations
    Replies: 1
    Last Post: 04-16-2010, 10:42 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.