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COLON CANCER SCREENING PLANS
The recommended colon cancer screening plan depends upon your risk of colorectal cancer.Average risk of colorectal cancer — People with an average risk of colorectal cancer should begin screening at...
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Benefit Criteria for Esophageal pH Probe Monitoring
Change for Texas Medicaid Effective for dates of services on or after April 1, 2011, benefit criteria for esophageal pH probe monitoring will change for Texas Medicaid. Procedure codes 78262, 91034,...
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ICD-9 Codes that Support Medical Necessity for colonoscopy procedures
009.0 - 009.1 INFECTIOUS COLITIS ENTERITIS AND GASTROENTERITIS - COLITIS ENTERITIS AND GASTROENTERITIS OF PRESUMED INFECTIOUS ORIGIN009.3 DIARRHEA OF PRESUMED INFECTIOUS ORIGIN038.9 UNSPECIFIED...
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When to use Colonoscopy DX V70.5, V70.9
We can use the following scenario.Individuals at average risk for colon cancer:• Colonoscopy covered once every 10 years beginning at age 50.Individuals at increased risk for colon cancer:• Colonoscopy...
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Colonoscopy CPT CODE LIST
44388 COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)44389 COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE44390...
View ArticleColonoscopy Screenings and Related Subsequent Diagnostic Procedures
Coding Tip for Preventing Service and ScreeningWhen a provider performs a separately identifiable medically necessary E/M service in addition to the IPPE, CPT codes 99201-99215 reported with modifier...
View ArticleHow to avoid an Appeal - part 1
• Verify all data pertaining to the service is correct. Correct data allows the service to process as is intended, eliminating the need to make corrections after the claim has processed.• Become...
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Become familiar with Local Coverage Determinations (LCD).• An LCD is a decision by a Medicare contractor whether to cover a particular item or service. LCDs contain âœreasonable and necessary...
View Articlenew colonospopy code for 2015 - CPT CODE 45399, 45378, 45380 , 45391, 45392
Colonoscopy Coding UpdatesNew definition. Colonoscopy is the examination of the entire colon, from the rectum to the cecum or colon-small intestine anastomosis, and may include the examination of the...
View ArticleMedicare Non Covered Services
Medicare does not cover items and services that are not reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body member. Section...
View ArticleCPT code 0226T, 0227T, 91200 , 3775F,
2015 New Update on GI billing CodesOther ChangesCategory I CodesHIGH RESOLUTION ANOSCOPYCategory III codes 0226T and 0227T were deleted and replaced with two new Category I codes for high-resolution...
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Crosswalking Certain CY 2014 Lower GI Endoscopy CPT Codes to 2015 HCPCS...
Important Correction in 2015 CPT coding Update in GI CodesBelow is the correct version of the Decision Tree. When coding a therapeutic procedure to the cecum, bill the appropriate colonoscopy CPT code...
View ArticlePart B: Importance of Documentation
This information is targeting physicians, non-physician practitioners and their staff who submit claims for services to the Medicare Part B Program.Key Points/Instruction/What you need to know• The...
View ArticleNew CPT Codes Not Recognized in CY 2015 by Medicare
In the final rule, CMS set the value of all other new lower GI endoscopy CPT codes at 0.00 RVUs. CMS has provided guidance as to how physicians should report new endoscopic procedures that CMS has...
View ArticleTimely Filing Requirements and exception cases
This article is intended for physicians and non-physician practitioners who submit claims for payment to the Medicare Part B Program.Key Points/Instruction/What You Need To Know• In general,...
View ArticleColonoscopy through Stoma CPT codes 44388, 44389, 44391, 44401
Colonoscopy through stoma has been specifically defined in CPT as the examination of the colon, from the colostomy stoma to the cecum or colon-small intestine anastomosis, and may include examination...
View ArticleGeneral Concepts for all GI Endoscopy Procedures
In recent years, the CPT Editorial Panel has been replacing the terminology “with or without” in codes throughout the CPT book with “including, when performed” in an effort to standardize the language...
View ArticleFlexible Sigmoidoscopy cpt code 45330, 45331, 45332, 45334
Flexible SigmoidoscopySpecific instructions for reporting flexible sigmoidoscopy have been added to the section guidelines. Report flexible sigmoidoscopy for endoscopic examination during which the...
View ArticleCPT CODE 44380, 44385 , 44799, 45399
EnteroscopyA new definition and instructions for reporting antegrade transoral small intestine endoscopy (i.e., enteroscopy) have been added to the section guidelines. Enteroscopy is defined by the...
View ArticleFrequently Asked Coding Questions on screening colonoscopy
Frequently Asked Coding QuestionsQUESTION: One of the most confusing aspects of gastroenterology billing is submitting claims for screening colonoscopy. Can you explain the differences between average...
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