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screening colon

  1. #1
    Default screening colon
    Exam Training Packages
    I am having the v76.49 and v76.51 deny on my Medicare claims for routine service. How would we bill for someone coming in for a visit because they want a screening done? No symptoms are present?

  2. #2
    Location
    Charlotte, NC
    Posts
    534
    Default
    You can submit the claim to Medicare for the visit prior to the actual screening procedure but you will never get paid for it because Medicare considers it part of the procedure and payment is bundled into payment for the procedure.

    It's one of the reasons many practices have an Open Access program.

  3. #3
    Default
    So, even if you use a screening code such as G0121 it will not be paid?

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    For the actual screening you wold use the V76.51 with the G0121, if it is not being paid it could be a timing issue you need to know when the last time was the patient had one. What does the denial say from Medicare?
    COACHLANG3 is referring to the visit prior to the colonoscopy. If that is what your question is regarding then you cannot use the G0121 for the office visit.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    Lauderdale Lakes
    Posts
    203
    Default
    If this is for an office visit, Medicare does not pay for the office visit for a screening. You would have to have the patient sign an ABN and the patient will be responsible for the office visit.

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