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Screening colonoscopies

  1. #1
    Default Screening colonoscopies
    Medical Coding Books
    Does anyone know when Medicare changed the rule that allows Screening colonoscopies for high risk patients once every 4 years to once every 2 years?

  2. #2
    Default
    Effective July 1, 2001, CMS expanded the colorectal screening benefit to include the G0121, colonoscopy for the average risk patient every 10 years. The benefit payable every 4 years is the G0104, screening sigmoidoscopy. See the CMS IOM #100-04, Chapter 18, Section 60. http://www.cms.gov/manuals/downloads/clm104c18.pdf
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3
    Location
    Greeley, Colorado
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    Default 24 months
    Medicare allows high risk patients to have a screening colonoscopy every 24 months.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Default
    High risk colonoscopies are covered by medicare once every 2 years.

  5. #5
    Default
    Also, just for verification purposes, per CMS a person is considered to be at high-risk if they have any of the following:
    -A close relative (sibling, parent, or child) who has had colorectal cancer or an adenomatous polyp
    -A family history of adenomatous polyposis
    -A family history of hereditary nonpolyposis colorectal cancer
    -A personal history of adenomatous polyps
    -A personal history of colorectal cancer
    -A personal history of inflammatory bowel disease, including Crohn's Disease and ulcerative colitis.

  6. #6
    Default
    Thanks, yes, we realize Screening colonoscopies for High risk patients are now covered every 2 years. But we want to know when it was changed to allow the patients to have one every 2 years...because my supervisor is telling me it use to be covered only every 4 or 5 years for high risk patients.
    Last edited by Colliemom; 12-03-2010 at 08:48 AM.

  7. Default
    Yes, your supervisor is correct. It was 48 months but changed I want to say 2006ish.. I can't find it in my archives.

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