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Thread: Medicare NP - unsure if this is billable?

  1. #1
    Join Date
    Apr 2007
    Lehigh Valley

    Default Medicare NP - unsure if this is billable?

    AAPC: Back to School
    We had a Medicare NP come in to the office for a screening colonoscopy visit. He underwent an incomplete colonoscopy in 2009 (only to the hepatic flexure) and now has bleeding hemorrhoids. He has no known hx of colon CA or polyps, however, does have a history of prostate and laryngeal CA and is concerned about having colon CA. Doctor wants to perform colonoscopy (we are general surgeons).

    Can this colonoscopy be billed? I know about the freuquency rules, but I am unsure since they could not completely do the colonoscopy, whether or not I can bill out the colonoscopy to Medicare.

    Thanks in advance for your help!

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    If the patient presents with rectal bleeding and the physician wants a colonoscopy to aide in diagnosing then it is not screening.

    Debra A. Mitchell, MSPH, CPC-H

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