tci General Surgery Coding Alert - 1999 Issue 1

How to Bill Medicare for Colonoscopy Screenings

HCFA pays for some colonoscopy screenings, but reimbursement is often difficult to obtain. Detailed and complex criteria must be met in order to qualify for Medicare reimbursement, and HCFAs regulations depend, in large part, on whether the patient has a family or personal history of colon problems.For example, HCFA permits individuals at risk for colon problems to receive a colonoscopy screening every two years, while those without family or personal history are not eligible at all. According to HCPCS 1999, Medicares National Level II Codes, the screening on patients at risk for colon problems is coded G0105, while...

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