decisionhealth Newsletters, Answer Books - 2015 Issue 1 (January)
Anesthesia for colon cancer screens
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Article Overview
This article covers a Medicare policy update affecting anesthesia services furnished with colorectal cancer screening colonoscopies. It is intended for anesthesia providers, coders, and compliance staff who need to understand the general scope of the change, the related modifier guidance, and the possibility of carrier and private payer denial issues.
Why This Topic Matters
The topic matters because changes in Medicare coverage policy can affect whether anesthesia services linked to screening colonoscopies are paid without patient cost-sharing and how claims are filed. It also highlights the need to watch for payer processing differences during policy transitions.
Article Sections
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No copay means complete, faster pay
Discusses the general payment and cost-sharing implications of the Medicare policy update for anesthesia services tied to screening colonoscopy services.
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Watch for denials in early 2015
Summarizes coverage and claims-processing concerns, including the possibility of denials during the transition to the new policy.
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Select a modifier based on the colonoscopy
Introduces the modifier guidance associated with anesthesia claims and notes that filing depends on what occurs during the colonoscopy.
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More guidance, private payer policies expected
Addresses remaining questions about compliance and mentions that private payer policies may continue to vary.
What You Will Learn
- How the Medicare policy change affects anesthesia services furnished with screening colonoscopies
- What general claims and coverage issues to watch for during policy implementation
- Which broad modifier-related topics are discussed for these anesthesia claims
- Why private payer policies may still differ from Medicare guidance
Who Should Read This
- Anesthesiologists
- Anesthetists
- Medical coders
- Billing staff
- Compliance professionals
Codes Discussed
Modifiers Discussed
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