Proposed physician fee schedule 2015: CMS to eliminate copay, add modifier for anesthesia with screening colonoscopy

Why This Topic Matters

The proposed policy could change how screening colonoscopy services involving anesthesia are reported and reimbursed under Medicare. It matters to organizations that code, bill, or audit these services because it touches fee schedule policy, diagnosis coding, and a new reporting modifier referenced in the proposal.

Article Sections

1. Overview of proposed fee schedule change

   Introduces the proposed Medicare policy changes affecting screening colonoscopy services and anesthesia reporting under the physician fee schedule.

2. Policy rationale and anesthesia reporting

   Summarizes the stated reason for the proposed change and the plan to add a reporting element for carriers to evaluate the service.

3. Tips for cleaning up colonoscopy coding

   Provides broad coding review points for screening and symptom-related colorectal exam claims, including diagnosis selection considerations.

4. Medical society response mixed

   Describes reactions from anesthesia and gastroenterology organizations and notes the differing views on the proposed policy.

5. Comment deadline

   Gives the public comment timing and references the CMS rulemaking comment process.