tci Part B Insider - 2004 Issue 19

Part B Coding Coach: 4 Tips Help You Master The 'Multiple Scope' Rule

Use caution for scopes in the same family, experts say When your surgeon performs several scopes on the same day, you'll need to know whether one of the endoscopes was a base procedure to bill these services correctly. Experts offer four basic pointers to guide your multiple endoscopy billing. 1. Look to CPT for Scope 'Families' Before worrying about how to apply the multiple endoscopy rule, you must first know why and when it applies. The multiple endoscopy rule is CMS' method to avoid paying twice (or more) for "inclusive" services by reimbursing only a portion of any endoscope...

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