General Surgery Coding Alert

Check diagnosis, risk level for medical necessity.Colonoscopy for cancer screening won't garner Medicare pay -- unless you follow frequency guidelines and eligibility requirements to the letter. Make sure you get all the colorectal cancer screening pay you deserve for your general surgery practice using these FAQs.Who's Eligible for Average-Risk Test?If the Medicare patient is 50-plus years old, he is eligible for a covered Medicare screening, explains Dena Rumisek, CPC, a biller in Grand Rapids, Michigan. However: These patients are considered average risk, and can have a colorectal cancer screening only once every 10 years, says Cheryl Ray, CCS, CPMA, of Atlantic Gastroenterology in Greenville, N.C."Medicare is very stringent on the date ... it has to be 10 years or longer -- it can't be 9 years and 360 days," between covered screening colonoscopies, confirms Rumisek.Example: A 68-year-old established Medicare patient reports for a screening colonoscopy on Dec. 5, 2010. The [...]