Wiki Anesthesia billing for colonoscopies

[ekfannin]

My group does the Anesthesia and is running into the problem that medicare isn't paying for colonoscopies or EGDs and because they won't other secondary insurances aren't paying either. We don't want to have the pt sign something saying they will pay if Medicare doesn't but it is looking like we might have to do that unless we can figure a way for Medicare to accept the Anesthesiologist is on staff and running anesthesia for the procedure. Does anyone have any suggestions so we don't have to bill the pt for routine procedures that they need? We are stumped!

 

[bwolfe1]

Medicare covers this test once every 24 months if you're at high risk for colorectal cancer. If you aren't at high risk for colorectal cancer, Medicare covers this test once every 120 months, or 48 months after a previous flexible sigmoidoscopy. Verify the diagnosis with the surgeon's office. If the patients are requesting the colonoscopy outside of the coverage period, you may want them to sign an ABN.

 

[doelkers]

What is the denial stating?
I bill/code for anesthesia group and handle all Medicare and haven't had any problems thus far