tci General Surgery Coding Alert - 2019 Issue 4

Reader Question: Check Out ABN Modifier Choices

Question: We have an ABN notice for a patient’s low-risk screening colonoscopy because the physician ordered the test five years after a normal test, meaning that it exceeds frequency limitations. What can we do to get paid for this test? Georgia Subscriber Answer: You’re in luck that you have an advance beneficiary notification (ABN), because without one, your surgeon wouldn’t get paid for the procedure. As you said, five years following a normal colonoscopy with no other symptoms and no high-risk for colon cancer is too soon for another screening procedure. The answer to your...

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