Wiki Can we Bill Again? Biopsy Lost

[Bnevin]

Hello all,
Looking for advice on how to code this scenario; the payor is Medicare.
Patient received a screening colonoscopy and biopsies were taken, specimens were sent to the path dept and LOST… the Doctor wants the patient to return for another colonoscopy to obtain more biopsies. Can we bill for the repeat procedure? (and yes, the first procedure has already been billed)
My first response was no, but would like additional advice, so what do you think?

Thank-you,
Betty
Kingman, Arizona

 

[mitchellde]

when it is not a procedure due to findings, symptoms or patient request then no you cannot bill for it. You need to repeat the procedure due to a failure at the lab, you cannot charge the patient or the payer for this.

 

[Bnevin]

Thank-you, I just need to hear the confirmation.