Diagnosis coding and screening colonoscopies: Medicare says prove its diagnosis coding policy denies beneficiaries colonoscopies

Article Overview

This article examines a Medicare diagnosis coding policy affecting screening colonoscopies that are converted to therapeutic procedures, along with concerns raised by GI practices about denied claims and beneficiary access. It summarizes guidance referenced in Medicare materials and ICD-9-CM coding guidelines, and notes the roles of CMS, payer denials, and specialty society advocacy. The piece is relevant to gastroenterology practices, coding staff, and compliance professionals working with Medicare colorectal screening claims.