tci Part B Insider - 2016 Issue 13

Compliance: CMS: Stop Reporting Diagnostic Colonoscopies for Screenings

Plus: Nerve conduction studies and observation services are also under the agency’s magnifying glass. Screening or diagnostic? The difference between these two words may be negligible to you—but that’s not how CMS feels. The agency is reminding practices that it’s inappropriate to report a diagnostic colonoscopy code to your insurer if the patient is in fact undergoing a service that’s considered “screening.” According to the April 2016 Medicare Quarterly Provider Compliance Newsletter, CMS’s CERT contractors are reporting that they have seen this issue multiple times. In some cases, it’s the...

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