tci Part B Insider - 2003 Issue 20

Interrupted Colonoscopy Same as Flexible Sigmoidoscopy

If your pathology Coder starts a colonoscopy covered by Medicare but can't finish it because of extenuating circumstances, you can still bill for a procedure.   The carriers should reimburse an interrupted colonoscopy at the rate for a flexible sigmoidoscopy, according to program memo AB-03-114, issued Aug. 1. You should make sure the procedure meets all the coverage criteria. And when the physician tries again later and completes a colonoscopy, Medicare will cover the completed procedure separately.   Add modifier -53 (Discontinued procedure) to the incomplete colonoscopy to obtain coverage, Medicare says. Ambulatory surgical centers seeking to bill for...

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