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Office Visits prior to Screening Colon

  1. #1
    Default Office Visits prior to Screening Colon
    Medical Coding Books
    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. I would like to hear how other offices are handling the office visits prior to screening colonoscopies. Do you charge for them? Thanks for your help.

  2. #2
    Location
    Ellenville, New York
    Posts
    1,176
    Default Clarification
    Is this the visit for the procedure itself or is this for a visit on a day prior to the visit? If the latter, what about a pre-op clearance or maybe addressing a S/S that while itself not the reason for a colonoscopy, the procedure is desired because of the S/S and other factors, such as age or family history? Just trying to get some clarification on what you are asking.

    Lance Smith, MPA, COC, CPMA, CEMC, RHIT, CCS-P, CHC, CHPC

    Director, Health Information Management
    HealthAlliance of the Hudson Valley
    Kingston, NY


    2016 Secretary
    Ellenville, NY Local Chapter

  3. #3
    Default
    Quote Originally Posted by rcclary View Post
    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. I would like to hear how other offices are handling the office visits prior to screening colonoscopies. Do you charge for them? Thanks for your help.
    For non-Medicare patients you can see the patient prior to a colonoscopy in the office and charge for an E/M service. If the patient is sent to your doctor in consult you use a consult code and the appropriate ICD-9 code.

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