tci General Surgery Coding Alert - 2022 Issue Q1

Medicare Coverage: Correctly File Screening Colonoscopy Claims with These Tips

CMS to phase out coinsurance for screenings that turn diagnostic. When your surgeon performs a screening colonoscopy or flexible sigmoidoscopy, you need to follow certain coverage and billing rules to secure your patient’s preventive service benefit of 100 percent coverage. But what happens when the surgeon finds and removes a polyp or other tissue of concern? That circumstance can leave the patient holding the bag for 25 percent of the bill instead of paying nothing. Relief: The Centers for Medicare and Medicaid Services (CMS) aims to fix the problem by phasing out coinsurance costs for CRC screening tests...

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