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Thread: Screening colonoscopies

  1. #1

    Default Screening colonoscopies

    AAPC: Back to School
    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
    Join Date
    Apr 2007


    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
    Join Date
    Apr 2007
    Greeley, Colorado

    Default 24 months

    Medicare allows high risk patients to have a screening colonoscopy every 24 months.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Join Date
    Apr 2007


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

  5. #5
    Join Date
    Apr 2007
    Redding, CA


    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


    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. #7


    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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