Gastroenterology Coding Alert

Question: We have been repeatedly getting denials for our anesthesia services. What can we do about this?

Kentucky Subscriber

Answer: Although Medicare covers anesthesia for colonoscopy as a preventive service, it is important that both the provider and the anesthetist document the services so as to justify the need for anesthesia during the procedure.

In case you billed for endoscopy, which is not a preventive service, some payors have policies that allow reimbursement for anesthesia, only when the anesthesia provider mentions the risk factors and comorbidities as the primary diagnosis, with appropriate documentation.

Remember: When the GI provides sedation there is no separate billing for the anesthesia.