DecisionHealth, DecisionHealth - 2009 Issue 8 (August)

Ask a Part B News Expert

Question: I'm trying to pin down Medicare's rules for 45378 (Diagnostic colonoscopy, $368.96) vs. G0121 (low risk screening colonoscopy, $368.96). A physician listed rectal bleeding as the primary diagnosis, but he states the procedure performed was a "screening colonoscopy." If coverage limitations are met and there aren't any other findings, how should we report it? It's my understanding that a screening is only indicated when the patient presents without any symptoms.

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