tci General Surgery Coding Alert - 2005 Issue 11

READER QUESTIONS: Here's How to Establish 'High Risk'

Question: Which ICD-9 codes prove medical necessity for Medicare's high-risk colorectal cancer screening?Missouri Subscriber Answer: When you report a high-risk colorectal cancer screening to Medicare (G0105, Colorectal cancer screening; colonoscopy on individual at high risk), the first step in proving medical necessity is strong diagnosis coding based on the patient's high-risk characteristics. To help remember which patients meet Medicare's requirements for payment, save this list of common ICD-9 codes that indicate a patient may be at high risk for colorectal cancer:- V10.05--Personal history of malignant neoplasm of large intestine- V10.06--Personal history of malignant neoplasm of rectum...

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