ngastroent
Guest
I've got a Medicare replacement plan who recouped several claims stating an EGD and colonoscopy shouldn't both be paid, which we know if not true as they've been classified as separate systems. Does anyone know exactly where to find that wording on CMS? I've searched enough I'm starting to go insane not finding that wording to prove that's not the case to appeal with. Being it's a replacement plan, they just follow Medicare's guidelines so I know it's not in a contract with the plan itself.