decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Medicare_Claims_Processing_Manual / Chapter_18 / 60.3
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Article Overview
This manual section explains who is considered at high risk for colorectal cancer and provides a partial list of example diagnosis codes associated with that status. It is useful for billing, coding, and compliance staff who need to understand Medicare’s high-risk colorectal cancer screening guidance and the kinds of diagnosis categories referenced in the policy.
Why This Topic Matters
The article helps readers determine whether a patient may fit Medicare’s high-risk colorectal cancer screening criteria and shows which diagnosis categories are referenced as examples in the manual. That makes it relevant for claim preparation, medical record review, and policy lookup.
Article Sections
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A - Characteristics of the High Risk Individual
Defines the broad clinical and family-history categories used to identify a high-risk individual for colorectal cancer screening purposes.
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B - Partial List of ICD-9-CM Codes Indicating High Risk
Provides example diagnosis categories and associated ICD-9-CM code listings referenced by the manual as indicators of high risk.
What You Will Learn
- The general criteria used to identify a high-risk individual for colorectal cancer screening
- That the article includes a partial list of diagnosis codes associated with high-risk status
- How the manual frames example diagnosis categories related to personal history and chronic digestive disease
- Which code set is referenced in the high-risk diagnosis list
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Revenue cycle professionals
- Clinical documentation reviewers
Codes Discussed
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