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Thread: E/M Visits prior to Screening Colon

  1. #1

    Default E/M Visits prior to Screening Colon

    AAPC: Back to School
    I know you cannot charge for an E/M visit for a screening colonoscopy with Medicare but what about other carriers. I am wanting to see what other offices are doing in this instance. I know some carriers will deny the claim for inconsistent coding. You cannot put a V code with an problematic E/M visit (e.g. V76.51 w/ 99203). BCBS will deny the claim but to the patient's responsibility stating preventative office visits are not covered. Can anyone tell me how their office handles office visits for screening colons? Do you charge for them? Thanks for your help.

  2. #2
    Join Date
    Apr 2007
    Lauderdale Lakes


    I have been billing the office visit codes with the V76.51. I even bill these to BC. Most insurance's have been paying. If the pt has a deductible then it goes to the deductible.

  3. #3
    Join Date
    Apr 2007


    How do you document the HPI for these visits? I'm auditing a GI provider billing a commercial carrier for what appears to be an initial office visit prior to a screening colonoscopy. 50 year old patient whose mother was recently dx w/colon ca.

  4. #4
    Join Date
    Apr 2007
    Kansas City, MO


    We don't bill these for any payer...and probably not a good idea to bill differently based on the payer.
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

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