Gastroenterology Coding Alert

Medicare typically will not cover (or reimburse you for) an E/M service prior to a screening colonoscopy for an asymptomatic patient.

In a recent article ("V Codes Can Make or Break Your Claim for Medicare Screening Services," Gastroenterology Coding Alert, Vol. 9, No. 12), a quote was accidentally taken out of context.

The erroneous statement at the end of the article indicates, "You can bill the patient, however, if you obtain an advance beneficiary notice (ABN) before the service," according to Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, CPC-EMS, RCC, CodeRyte coding analyst and coding review teacher.

Although you can obtain an ABN for a procedure that is considered medically unnecessary, you cannot use an ABN for an E/M service that Medicare considers inclusive to a procedure.

In other words: You cannot use an ABN for a prescreening colonoscopy service.