tci Part B Insider - 2016 Issue 26

Part B Coding Coach: Frequency Is A Factor When Coding Colonoscopies

Consider risk and frequency when choosing the right codes for colon-related procedures. Are you mystified by the extent of coverage for screening colonoscopies, and what to do when these procedures turn diagnostic or therapeutic midway through the process? “Many providers are confused about the definition of screening because the codes can vary between average-risk screening and for high-risk screening. If the provider does not make the patient’s risk status clear in the report then mistakes may occur with claims,” says Michael Weinstein, MD, former representative of the AMA’s CPT® Advisory Panel. Important: As per Medicare...

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