HCPro, JustCoding Outpatient - 2017 Issue 19 (May)
Healthcare News: CMS provides guidance on colorectal cancer screening claims payments
May 5th, 2017
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Article Overview
This article explains a CMS change request affecting Medicare claims processing for colorectal cancer screening services. It focuses on how Medicare Administrative Contractors should handle payment accuracy, cost-sharing treatment, and claim adjustments for moderate sedation services tied to screening colonoscopies. The piece is relevant to outpatient coders, billing staff, and revenue cycle teams working with Medicare preventive services and colonoscopy-related claims.
Why This Topic Matters
The guidance affects how screening colonoscopy claims are paid and whether cost-sharing is applied, which can directly influence claim accuracy and beneficiary billing. It is important for teams that submit or review Medicare preventive-service claims and need to understand the scope and timing of CMS implementation.
What You Will Learn
- How CMS guidance affects Medicare claim payment processing for screening colonoscopy-related services
- What types of claim submissions are affected by the change request
- How the article frames the timing and implementation of the CMS guidance
- What role Medicare Administrative Contractors play in applying the guidance
Who Should Read This
- Medical coders
- Outpatient facility coders
- Physician office billing staff
- Revenue cycle specialists
- Compliance teams
- Medicare claims processors
Codes Discussed
Modifiers Discussed
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