Q&A: Screening or diagnostic colonoscopy?
Physician Practice Insider, July 28, 2015
Do you have questions about physician practice coding, reimbursement, safety, EHRs, compliance, HIPAA, or other topics? Send your questions to Editor John Castelluccio and we’ll work with our experts to find you an answer.
Q: There is confusion in our office about billing for a screening versus diagnostic colonoscopy after having a positive screening of a fecal immunochemical test (FIT) or fecal occult blood test (FOBT). Since these tests are now being used for screening tools, if the test was positive and the need for a colonoscopy would be your next step, should it be billed as a screening colonoscopy or diagnostic?
A: If screening tests (FIT or FOBT) are coming back positive that would convert what may have been a screening colonoscopy into a diagnostic test for Medicare purposes. If the patient is not showing any symptoms, however, they may wish to verify with their commercial payers. Not all payers may consider FIT or FOBT screening tests but may still allow for a screening benefit for colonoscopy (which usually is a better benefit for the patient).
Editor's note: This question was answered by Jillian Harrington, MHA, CPC, CPC-I, CPC-P, CCS, CCS-P, MHP, an HCPro Boot Camp Instructor and regulatory specialist. This information does not constitute legal advice.
Related Products
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Complications from immobility by body system
- Differentiate between types of wound debridement
- OB services: Coding inside and outside of the package
- Q&A: Primary, principal, and secondary diagnoses
- Nursing responsibilities for managing pain
- The consequences of an incomplete medical record
- Practice the six rights of medication administration
- CDC alert: Screen for international travel as Ebola cases increase
- E-mailed
-
- CDC alert: Screen for international travel as Ebola cases increase
- Differentiate between types of wound debridement
- Q&A: Bill blood administration the same way for inpatient and outpatient accounts
- Q&A: A second look at encephalopathy as integral to seizures/CVA
- Performing a SWOT analysis
- Leadership training for charge nurses
- Helping Charge Nurses understand their leadership role (Part 2 of 3)
- Developing a Fall-Prevention Program
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Coding tip: Watch for different codes for SI joint injections
- Searched