decisionhealth Newsletters, Coder Pink Sheets - 2010 Issue 9 (September)
Gastroenterology RoundUp: E/M with screening colonoscopy
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Article Overview
This article is for gastroenterology and coding professionals who need to understand how Medicare views evaluation and management visits around colonoscopy services. It discusses the broad policy context, including screening versus diagnostic colonoscopy, Medicare statutory language, and CMS-related coding guidance sources that affect whether a separate office visit may be reported.
Why This Topic Matters
It helps readers assess whether a pre-procedure visit is likely to be considered part of the colonoscopy service under Medicare policy and where official guidance is grounded. This is relevant for avoiding billing errors and understanding how Medicare policy differs across screening and diagnostic scenarios.
Article Sections
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Question
Introduces the billing concern and the general scenario involving office visits before colonoscopy for Medicare patients.
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Answer
Summarizes the Medicare policy context, including references to screening colonoscopy, diagnostic colonoscopy, and federal and CMS guidance sources.
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Official resource
Lists the referenced CMS resource for the coding policy manual.
What You Will Learn
- How the article frames Medicare policy issues around colonoscopy-related office visits
- Which general policy sources are cited for screening and diagnostic colonoscopy guidance
- Why the article distinguishes between screening and diagnostic colonoscopy contexts
- What official CMS resource is referenced for additional policy information
Who Should Read This
- Medical coders
- Billing staff
- Gastroenterology practices
- Compliance professionals
- Physician office administrators
Codes Discussed
Code Ranges Discussed
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